Individual provider Active NPI

Meleecia Tucker, LMHC

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1043632102
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH7573 Issued in FL
Practice address
4417 Beach Blvd Ste 101
Jacksonville, FL 32207-4728
Phone
(904) 551-4953
Fax
(904) 212-2366
NPI assigned
Jan 9, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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 MH7573 FL Primary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 2805 FL

Addresses

Primary practice location

4417 Beach Blvd Ste 101
Jacksonville, FL 32207-4728

Mailing address

3636 University Blvd S Ste A9
Jacksonville, FL 32216-4209
Phone (904) 536-4415

Other names 1

  • Mrs. Meleecia McCoy Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231117001845 FL Practitioner - Mental Health Counselor 2567870876 Reassigns benefits to 2 organizations
I20250222000097 MI Practitioner - Mental Health Counselor 2567870876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4417 Beach Blvd
Suite 101
Jacksonville, FL 32207-4728
Phone (904) 551-4953

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2805FLMDAddiction (Substance Use Disorder) Counselor
MH7573FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince Jan 17, 2025 Accepting new patients
New Life Counseling and Educational Services Addiction (Substance Use Disorder) CurrentSince Mar 28, 2020 Accepting new patients
New Life Counseling and Educational Services Current Accepting new patients
New Life Counseling and Educational Services Multipurpose Center Inc Addiction (Substance Use Disorder) Current Accepting new patients

Locations

4417 Beach Blvd
Ste 101
Jacksonville, FL 32207
Phone (904) 551-4953

4124 Boulevard Center Dr
Jacksonville, FL 32207

3636 University Blvd S
Ste A9
Jacksonville, FL 32216
Phone (904) 551-4953

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

250 Monroe Ave NW
Ste 400
Grand Rapids, MI 49503
Phone (616) 441-4616

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1389225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1043632102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3636 UNIVERSITY BLVD S STE A9",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164209",
            "telephone_number": "904-536-4415",
            "fax_number": "904-575-4162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4417 BEACH BLVD STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322074728",
            "telephone_number": "904-551-4953",
            "fax_number": "904-212-2366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "MELEECIA",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-09",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH7573",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "2805",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELEECIA",
            "last_name": "MCCOY",
            "prefix": "MRS.",
            "credential": "LMHC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.