Individual provider Active NPI

Emily Tucker, LPC NCC

  • Professional Counselor
  • Roseburg, OR
National Provider Identifier
1013210681
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C10100 Issued in OR
Practice address
621 W Madrone St
Roseburg, OR 97470-3090
Phone
(541) 672-2691
NPI assigned
Dec 21, 2010
Last updated
Jul 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2798 AL
Professional Counselor 101YP2500X C10100 OR Primary

Addresses

Primary practice location

621 W Madrone St
Roseburg, OR 97470-3090

Mailing address

PO Box 1121
Roseburg, OR 97470-0254
Phone (541) 672-2691

Other practice location 1

300 Office Park Dr
Suite 220
Mountain Brk, AL 35223-2474
Phone (205) 370-8533

Other practice location 2

1940 Highway 33 Unit A
Pelham, AL 35124-4887
Phone (205) 664-4010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250808000219 OR Practitioner - Mental Health Counselor 0143728220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
AdaptGroup PAC ID 4587662887, 43 clinicians

Practice addresses (Care Compare)

671 SW Main St
Winston, OR 97496-6571
Phone (541) 492-4550

PO Box
Suite 12
Winston, OR 97496

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C10100ORMDProfessional Counselor
2798ALMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Adapt CurrentSince Jul 7, 2025 Accepting new patients
Adapt Mental Health Current Accepting new patients
Adapt CurrentSince Jul 7, 2025 Accepting new patients
Adapt Past Accepting new patients

Locations

548 SE Jackson St
Roseburg, OR 97470
Phone (541) 492-0241

621 W Madrone St
Roseburg, OR 97470
Phone (541) 440-3571

Networks

  • WA PPO C-SNP
  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1292889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1013210681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1121",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974700254",
            "telephone_number": "541-672-2691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 W MADRONE ST",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974703090",
            "telephone_number": "541-672-2691"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Office Park Dr",
            "address_2": "Suite 220",
            "address_purpose": "LOCATION",
            "city": "Mountain Brk",
            "state": "AL",
            "postal_code": "352232474",
            "country_code": "US",
            "telephone_number": "205-370-8533",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1940 Highway 33 Unit A",
            "address_purpose": "LOCATION",
            "city": "Pelham",
            "state": "AL",
            "postal_code": "351244887",
            "country_code": "US",
            "telephone_number": "205-664-4010",
            "fax_number": "205-664-9928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "EMILY",
        "credential": "LPC NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-21",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AL",
            "license": "2798",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C10100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

Verify at the official NPI Registry.