Daveisha Mercedes Tanck, LCSWA
Social Worker, Clinical in Mooresville, NC. Individual provider (NPI-1).
NPI number1154840486
StatusActive
Last updated in NPPESJun 10, 2020
Details
- NPI
- 1154840486
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Daveisha Mercedes Tanck
- Credential
- LCSWA
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 19, 2017
- Certification date
- Jun 10, 2020
- Last updated
- Jun 10, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | C012880 | NC | Yes |
Practice location
919 N Main St Ste BMooresville, NC 28115-2355
Phone 561-317-2777
Mailing address
7943 Rolling Meadows LnHuntersville, NC 28078-3349
Phone 561-317-2777
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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