Melissa Renee Tucker, LPC-MHSP, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6286 Issued in TN

Practice address

701 Med Tech Pkwy Ste 200
Johnson City, TN 37604-2371

Phone

(423) 302-3480

NPI assigned

Sep 8, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: melissa.tucker.1@20785.direct.athenahealth.com

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.

• Counseling and Consultaion Services, Inc.

  • Mental Health Counselor
  • Limestone, TN
  • NPI 1316035157
  NPD (past)

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

{
    "created_epoch": "1694131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1053198515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-302-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 MED TECH PKWY STE 200",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042371",
            "telephone_number": "423-302-3480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Steppenstone Blvd",
            "address_purpose": "LOCATION",
            "city": "Limestone",
            "state": "TN",
            "postal_code": "376812740",
            "country_code": "US",
            "telephone_number": "423-257-6054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "MELISSA",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "LPC-MHSP, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-08",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "6286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Truelight Eye Care, PLLC
• Elizabeth Ann Truman, FNP-C
• Thomas A Truman, PA-C
• Trusted Benefits
• Joseph T Tucciarone Jr., PSYCHOLOGY INTERN
• William D. Tucker, MD
• Fraser G Tudiver, M.D.
• Judith G Tudiver, PH.D.
• Dawn S Tuell, MD
• Laura Dawn Tugman, PHD

• Mental Health Counselor in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Mental Health Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.