Provider Demographics
NPI:1194168872
Name:TUCKER, AMBER (CSW-PIP)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:TUCKER
Suffix:
Gender:F
Credentials:CSW-PIP
Other - Prefix:
Other - First Name:AMBERLY
Other - Middle Name:
Other - Last Name:EKEREN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:103 CURLIE ST
Mailing Address - Street 2:
Mailing Address - City:YANKTON
Mailing Address - State:SD
Mailing Address - Zip Code:57078-4727
Mailing Address - Country:US
Mailing Address - Phone:605-661-9076
Mailing Address - Fax:
Practice Address - Street 1:103 CURLIE ST
Practice Address - Street 2:
Practice Address - City:YANKTON
Practice Address - State:SD
Practice Address - Zip Code:57078-4727
Practice Address - Country:US
Practice Address - Phone:605-661-9076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-11
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD49191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical