Provider Demographics
NPI:1851641682
Name:TUCKER, JAMES H (LCSW)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:H
Last Name:TUCKER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 N ALABAMA ST STE 320
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-1432
Mailing Address - Country:US
Mailing Address - Phone:317-644-7257
Mailing Address - Fax:317-464-9575
Practice Address - Street 1:615 N ALABAMA ST STE 320
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-1432
Practice Address - Country:US
Practice Address - Phone:317-644-7257
Practice Address - Fax:317-464-9575
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34006336A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical