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Organization
TUCKERVILLE TRANSITIONS
Active
Organization
TUCKERVILLE TRANSITIONS
Active
Other names
FARTIMA TUCKER
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FARTIMA TUCKER LMSW, CCTP, EAS-C (OWNER, CLINICAL PSYCHO-THERAPIST)
(313) 303-7423
Entity
Organization
Contact information
Practice address
35230 E MICHIGAN AVE, WAYNE, MI 48184-3698
(313) 303-7423
Mailing address
PO BOX 125, BELLEVILLE, MI 48112-0125
(313) 312-5706
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8025368
—
MI
Enumeration date
07/13/2020
Last updated
03/08/2025
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