| Tucker Consulting | |
|
120 Mandy Dr Athens GA 30601-2117 | |
| (706) 352-9482 | |
| Not Available |
| Full Name | Tucker Consulting |
|---|---|
| Speciality | Social Worker |
| Location | 120 Mandy Dr, Athens, Georgia |
| Authorized Official Name and Position | Lynette Clark (CREDENTIALING MANAGER) |
| Authorized Official Contact | 7703397667 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tucker Consulting 120 Mandy Dr Athens GA 30601-2117 Ph: (706) 352-9482 | Tucker Consulting 120 Mandy Dr Athens GA 30601-2117 Ph: (706) 352-9482 |
| NPI Number | 1265109284 |
|---|---|
| Provider Enumeration Date | 08/26/2021 |
| Last Update Date | 08/26/2021 |
| Certification Date | 08/26/2021 |
| Medicare PECOS PAC ID | 4082010822 |
|---|---|
| Medicare Enrollment ID | O20210902002266 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265109284 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Robert D Tucker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326621756 PECOS PAC ID: 5991101735 Enrollment ID: I20210902002379 |
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