Active NPI
Renita Joyce Tackett, LPCC
- Counselor
- Pikeville, KY
National Provider Identifier
1003113648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- KY1031
- Practice address
- 146 Church of Christ Way
Fords Branch Church of Crist
Pikeville, KY 41501-8944 - Phone
- (606) 213-7830
- NPI assigned
- Feb 17, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | KY1031 | KY | Primary |
Addresses
Primary practice location
146 Church of Christ Way
Fords Branch Church of Crist
Pikeville, KY 41501-8944
Mailing address
155 Little Creek Road
Pikeville, KY 41501
Phone (606) 639-2969
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| KY1031 | KY | MD | Counselor |
Networks
- KY PPO
- KY PPO C-SNP
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440028800000",
"number": "1003113648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 LITTLE CREEK ROAD",
"city": "PIKEVILLE",
"state": "KY",
"postal_code": "41501",
"telephone_number": "606-639-2969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "146 CHURCH OF CHRIST WAY",
"address_2": "FORDS BRANCH CHURCH OF CRIST",
"city": "PIKEVILLE",
"state": "KY",
"postal_code": "415018944",
"telephone_number": "606-213-7830"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TACKETT",
"first_name": "RENITA",
"middle_name": "JOYCE",
"name_prefix": "Mrs.",
"credential": "LPCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-02-17",
"last_updated": "2015-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "KY",
"license": "KY1031",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pikeville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.