Tucker Keatley, LMSW-CLINICAL

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801108948 Issued in MI

Practice address

405 W Greenlawn Ave Ste 305
Lansing, MI 48910-2889

Phone

(517) 346-8318

NPI assigned

Mar 21, 2018

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tucker.keatley.p1@direct.ichd.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• County of Ingham

  • Federally Qualified Health Center (FQHC)
  • Lansing, MI
  • NPI 1568560308
  Medicare reassignment NPD
• Community Mental Health Authority of Clinton Eaton Ingham Counties

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lansing, MI
  • NPI 1265483457
  Medicare reassignment
• County of Ingham

  • Federally Qualified Health Center (FQHC)
  • Lansing, MI
  • NPI 1518339654
  NPD
• County of Ingham

  • Public Health or Welfare Agency
  • Lansing, MI
  • NPI 1902453145
  NPD
• County of Ingham

  • Federally Qualified Health Center (FQHC)
  • Lansing, MI
  • NPI 1639422728
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1821592296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2798 ROSELAND AVE",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488234752",
            "telephone_number": "734-415-4845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W GREENLAWN AVE STE 305",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489102889",
            "telephone_number": "517-346-8318"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2798 Roseland Ave",
            "address_purpose": "LOCATION",
            "city": "East Lansing",
            "state": "MI",
            "postal_code": "488234752",
            "country_code": "US",
            "telephone_number": "734-415-4845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEATLEY",
        "first_name": "TUCKER",
        "name_prefix": "Mr.",
        "credential": "LMSW-CLINICAL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-21",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "LA",
            "license": "14677",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "14677",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801108948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Kreutzer Counseling
• Lauren Kaylor, PA-C
• Christopher E Kazor, DDS, MS, PHD
• Alexandra Kearney
• Kathleen Elizabeth Keating, CRNA
• Thomas W Keaveney, M.D.
• Rebekah Keeder
• James Keel
• Margaret M Keeler, NP
• Michelle Renee Keever

• Clinical Social Worker in Lansing, MI
• Providers in Lansing, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.