Ellen Wall Tucker is a Clinical in Boulder, Colorado. Ellen Wall Tucker practices all healthcare services and medical treatments related to Clinical. The NPI Number for Ellen Wall Tucker is 1124291315. The last update date is 2017-11-10.
Ellen Wall Tucker's current location address is 5450 Western Ave, Boulder, Colorado. You can contact this provider via phone number 3034158850 and fax number 3034158870. The mailing address for Ellen Wall Tucker is 5450 Western Ave, Boulder, Colorado. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Ellen Wall Tucker |
|---|---|
| Address | 5450 Western Ave, Boulder, Colorado |
| Phone Number | 3034158850 |
| Fax Number | 3034158870 |
| Sole Proprietor | N |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1124291315 |
|---|---|
| Provider Enumeration Date | 2008-04-08 |
| Last Updated Date | 2017-11-10 |
Provider Mailing Address Detail
| Address | 5450 Western Ave |
|---|---|
| City | Boulder |
| State | Colorado (CO) |
| Post Code | 803012709 |
| Phone Number | 3034158850 |
| Fax Number | 3034158870 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | CSW.00000120 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 71927760 | CO | -- |
Post Comment/ Review Below
What is the Ellen Wall Tucker's 1124291315?
The Ellen Wall Tucker's NPI (National Provider Identifier) Number is 1124291315. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you kindly provide the complete physical address where Ellen Wall Tucker's facilities are geographically located?
The facilities of Ellen Wall Tucker are physically situated at the following location: 5450 Western Ave, Boulder, CO, 803012709.
What is Ellen Wall Tucker's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Ellen Wall Tucker is Clinical, and the corresponding taxonomy classification code for this specialized field is 1041C0700X.
On what date did the Centers for Medicare & Medicaid Services assign the 1124291315 to Ellen Wall Tucker?
The Centers for Medicare & Medicaid Services assigned the 1124291315 to Ellen Wall Tucker on 2008-04-08.
As of what date was the information regarding Ellen Wall Tucker, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Ellen Wall Tucker, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2017-11-10.
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