Active NPI
Peggie K Tucker, LICSW
- Counselor
- Madison, AL
National Provider Identifier
1124662978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 0260-0931C
- Practice address
- 814 Palmer Rd Ste B4
Madison, AL 35758-3185 - Phone
- (256) 325-0467
- Fax
- (256) 325-0469
- NPI assigned
- Nov 5, 2019
- Last updated
- Nov 5, 2019
- 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 | 0260-0931C | AL | Primary |
Addresses
Primary practice location
814 Palmer Rd Ste B4
Madison, AL 35758-3185
Mailing address
6611 Lizzie LN SE
Owens Cross Roads, AL 35763-9358
Phone (256) 603-5166
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0260-0931C | AL | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vallis LLC | Past | Accepting new patients |
Organizations & group practices 1
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": "1572912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572912000000",
"number": "1124662978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6611 LIZZIE LN SE",
"city": "OWENS CROSS ROADS",
"state": "AL",
"postal_code": "357639358",
"telephone_number": "256-603-5166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "814 PALMER RD STE B4",
"city": "MADISON",
"state": "AL",
"postal_code": "357583185",
"telephone_number": "256-325-0467",
"fax_number": "256-325-0469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUCKER",
"first_name": "PEGGIE",
"middle_name": "K",
"name_prefix": "Ms.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-11-05",
"last_updated": "2019-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "AL",
"license": "0260-0931C",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.