Provider Demographics
NPI:1871761064
Name:SCHLUCKEBIER, TOM (LCSW, BCC CAND)
Entity type:Individual
Prefix:
First Name:TOM
Middle Name:
Last Name:SCHLUCKEBIER
Suffix:
Gender:M
Credentials:LCSW, BCC CAND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6239 COLLEGE AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-1329
Mailing Address - Country:US
Mailing Address - Phone:510-849-7163
Mailing Address - Fax:888-777-0950
Practice Address - Street 1:6239 COLLEGE AVENUE
Practice Address - Street 2:SUITE 302
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618
Practice Address - Country:US
Practice Address - Phone:510-849-7163
Practice Address - Fax:888-777-0950
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-11
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS210951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALCS 21095OtherCA LICENSE