Paul Tucker, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2063 Issued in OK

Practice address

527 W 3Rd St
Konawa, OK 74849

Phone

(580) 925-3286

Fax

(580) 925-2362

NPI assigned

Oct 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427932800000",
    "number": "1861574717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 W 3RD ST",
            "address_2": "PO BOX 358",
            "city": "KONAWA",
            "state": "OK",
            "postal_code": "74849",
            "telephone_number": "580-925-3286",
            "fax_number": "580-925-2362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 W 3RD ST",
            "city": "KONAWA",
            "state": "OK",
            "postal_code": "74849",
            "telephone_number": "580-925-3286",
            "fax_number": "580-925-2362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2015-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "2063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Leah Sitton
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• The Script Shop Inc
• Larna Louise Tribbey, LPC
• Marvin Charles Turner Jr.
• Toni Faye Vandegrift, DPH
• Destinie Rose Vincent
• Tina Marie Wainwright, P.A-C
• Phyllis A Wallace, APRN

• Clinical Social Worker in Konawa, OK
• Providers in Konawa, OK by specialty
• Clinical Social Worker in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.