Provider Demographics
NPI:1821794124
Name:TUCKER, MARGARET MARY (LCSWA)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:MARY
Last Name:TUCKER
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 SARDIS RD N STE M
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-7712
Mailing Address - Country:US
Mailing Address - Phone:704-344-0491
Mailing Address - Fax:
Practice Address - Street 1:2300 SARDIS RD N STE M
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28227-7712
Practice Address - Country:US
Practice Address - Phone:704-344-0491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0185921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical