Provider Demographics
NPI:1578979472
Name:TUCK, ALEXANDRA NEGRON (LCSW, MSW)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:NEGRON
Last Name:TUCK
Suffix:
Gender:F
Credentials:LCSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 N SALISBURY AVE
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-8543
Mailing Address - Country:US
Mailing Address - Phone:704-680-1983
Mailing Address - Fax:
Practice Address - Street 1:110 A EAST MAIN ST
Practice Address - Street 2:
Practice Address - City:ROCKWELL
Practice Address - State:NC
Practice Address - Zip Code:28138-8806
Practice Address - Country:US
Practice Address - Phone:704-279-0626
Practice Address - Fax:704-279-0344
Is Sole Proprietor?:No
Enumeration Date:2014-07-11
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0103301041C0700X
NCP0089921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical