Individual provider Active NPI

Tucker Reynolds, LCMHC

  • Mental Health Counselor
  • Draper, UT
National Provider Identifier
1063203545
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
13411968-6004 Issued in UT
Practice address
14309 S Mayfield Dr
Draper, UT 84020-8177
Phone
(801) 688-6873
NPI assigned
May 14, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 13411968-6004 UT Primary

Addresses

Primary practice location

14309 S Mayfield Dr
Draper, UT 84020-8177

Mailing address

3725 W 4100 S Ste 201
West Valley City, UT 84120-6490
Phone (801) 688-6873

Other practice location 1

12427 S Pasture Rd Ste 104
Riverton, UT 84096-4828
Phone (888) 949-4864

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

LicenseStateTypeSpecialty
13411968-6004UTMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1747180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1063203545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3725 W 4100 S STE 201",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841206490",
            "telephone_number": "801-688-6873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14309 S MAYFIELD DR",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840208177",
            "telephone_number": "801-688-6873"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12427 S Pasture Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Riverton",
            "state": "UT",
            "postal_code": "840964828",
            "country_code": "US",
            "telephone_number": "888-949-4864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "TUCKER",
        "credential": "LCMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-14",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "13411968-6004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Draper, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.