Provider Demographics
NPI:1801189428
Name:TUCKER, JOAN E (LISW)
Entity type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:E
Last Name:TUCKER
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2774 TALISMAN CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43209-3166
Mailing Address - Country:US
Mailing Address - Phone:614-216-0821
Mailing Address - Fax:614-237-9736
Practice Address - Street 1:3964 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:OH
Practice Address - Zip Code:43213-2949
Practice Address - Country:US
Practice Address - Phone:614-589-5943
Practice Address - Fax:614-237-9736
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-16
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
OHI.00040361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical