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Organization

TUCKERVILLE TRANSITIONS ORG

Active
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Organization

TUCKERVILLE TRANSITIONS ORG

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. FARTIMA TUCKER LMSW, PHD (PRESIDENT)
(313) 303-7423
Entity
Organization

Contact information

Practice address
35230 E MICHIGAN AVE, WAYNE, MI 48184-3698
(313) 303-7423
(734) 345-4104
Mailing address
PO BOX 125, BELLEVILLE, MI 48112-0125
(313) 303-7423
(734) 345-4104

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
172V00000X
Community Health Worker
—
—
251V00000X
Voluntary or Charitable Agency
—
—
385HR2055X
Child Mental Illness Respite Care
—
—

Other

Enumeration date
07/24/2021
Last updated
03/08/2025
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