Provider Demographics
NPI:1144352071
Name:TUCHMAN, JACK (LICSW)
Entity type:Individual
Prefix:MR
First Name:JACK
Middle Name:
Last Name:TUCHMAN
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 E 60TH ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1002
Mailing Address - Country:US
Mailing Address - Phone:212-326-8441
Mailing Address - Fax:
Practice Address - Street 1:51 W 51ST ST STE 340
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1951
Practice Address - Country:US
Practice Address - Phone:212-326-8441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY04402611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical