Individual provider Active NPI

Tom Schluckebier, LCSW, BCC CAND.

  • Clinical Social Worker
  • Oakland, CA
National Provider Identifier
1871761064
Registry record updated Jul 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS21095 Issued in CA
Practice address
6239 College Avenue
Suite 302
Oakland, CA 94618
Phone
(510) 849-7163
Fax
(888) 777-0950
NPI assigned
Feb 11, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS21095 CA Primary

Addresses

Primary practice location

6239 College Avenue
Suite 302
Oakland, CA 94618

Mailing address

6239 College Ave
Suite 302
Oakland, CA 94618-1329
Phone (510) 849-7163

Other identifiers 1

IdentifierTypeStateIssuer
LCS 21095OtherCACA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LCS21095CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406764800000",
    "number": "1871761064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6239 COLLEGE AVE",
            "address_2": "SUITE 302",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946181329",
            "telephone_number": "510-849-7163",
            "fax_number": "888-777-0950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6239 COLLEGE AVENUE",
            "address_2": "SUITE 302",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "94618",
            "telephone_number": "510-849-7163",
            "fax_number": "888-777-0950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHLUCKEBIER",
        "first_name": "TOM",
        "credential": "LCSW, BCC CAND.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-11",
        "last_updated": "2014-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS21095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA LICENSE",
            "identifier": "LCS 21095",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2014; 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.