Provider Demographics
NPI:1962728444
Name:RANSON, TUCKER (LCSW)
Entity type:Individual
Prefix:MR
First Name:TUCKER
Middle Name:
Last Name:RANSON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:ST. GEORGE
Other - Middle Name:TUCKER
Other - Last Name:RANSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCS
Mailing Address - Street 1:359 E 19TH ST
Mailing Address - Street 2:2R
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-2833
Mailing Address - Country:US
Mailing Address - Phone:212-979-8433
Mailing Address - Fax:
Practice Address - Street 1:462 1ST AVE
Practice Address - Street 2:20 S 18
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9196
Practice Address - Country:US
Practice Address - Phone:212-562-4285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-09
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0736811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical