MEDICARE: MELISSA TUCK LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	848	WY

General Provider Information

NPI Number	:	1417399197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA TUCK LCSW

Provider Business Mailing Address
First Line	:	2695 ROCKY MOUNTAIN AVE STE 150
Second Line	:
City	:	LOVELAND
State	:	CO
Zip	:	80538-9071
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1107 S LEMAY AVE STE 100
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-3956
Country	:	US
Telephone Number	:	970-207-4857
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2013
Last Update Date	:	02/09/2026

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