Provider Demographics
NPI:1588736417
Name:TUCK, FRANCES YVONNE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:FRANCES
Middle Name:YVONNE
Last Name:TUCK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:FRANCES
Other - Middle Name:YVONNE
Other - Last Name:FISHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:34 ROYAL CREST DR
Mailing Address - Street 2:APT 11
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-2433
Mailing Address - Country:US
Mailing Address - Phone:207-841-8957
Mailing Address - Fax:
Practice Address - Street 1:251 W CENTRAL ST
Practice Address - Street 2:SUITE 25
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-3758
Practice Address - Country:US
Practice Address - Phone:508-653-4820
Practice Address - Fax:508-653-4827
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0171721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME432397599Medicaid