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
- 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 and National Provider Directory roles.
-
- Mental Health Counselor
- Madison, AL
- NPI 1144785940
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.