Individual provider Active NPI

Ronetta A. Tucker, LPCC

  • Professional Counselor
  • Prestonsburg, KY
National Provider Identifier
1174637730
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
270486 Issued in KY
Practice address
104 S Front Ave
Prestonsburg, KY 41653-1614
Phone
(606) 886-8572
Fax
(606) 886-4433
NPI assigned
Aug 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2021

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 0371 KY
Professional Counselor 101YP2500X 270486 KY Primary

Addresses

Primary practice location

104 S Front Ave
Prestonsburg, KY 41653-1614

Mailing address

104 S Front Ave
Prestonsburg, KY 41653-1614
Phone (606) 886-8572

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20240131003686 KY Practitioner - Mental Health Counselor 9234582701 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0371KYMDMental Health Counselor
270486KYMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Comprehensive Care Center, Inc. CurrentSince Dec 4, 2023 Accepting new patients
Mountain Comprehensive Care Center, Inc. Mental Health Current Accepting new patients
Mountain Comprehensive Care Center, Inc. CurrentSince Dec 4, 2023 Accepting new patients
Mountain Comprehensive Care Center, Inc. Past Accepting new patients
Mountain Comprehensive Care Center, Inc. Past Accepting new patients
Mountain Comprehensive Care Center, Inc. Past Accepting new patients
Mountain Comprehensive Care Center, Inc. Past Accepting new patients
Mountain Comprehensive Care Center, Inc. Past Accepting new patients
Mountain Comprehensive Care Center, Inc. Past Accepting new patients
Mountain Comprehensive Care Center, Inc. Past Accepting new patients

Locations

29 Cabin Frk
Jenkins, KY 41537

263 Ky Route 122
Martin, KY 41649
Phone (606) 949-1555

838 S Mayo Trl
Ste A
Paintsville, KY 41240

838 S Mayo Trl
Paintsville, KY 41240
Phone (606) 788-1345

1110 S Mayo Trl
Paintsville, KY 41240
Phone (606) 788-1345

118 River Dr
Pikeville, KY 41501
Phone (606) 432-3143

118 S Front Ave
Prestonsburg, KY 41653

104 S Front Ave
Prestonsburg, KY 41653
Phone (606) 688-6857

Organizations & group practices 10

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1174637730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 S FRONT AVE",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416531614",
            "telephone_number": "606-886-8572",
            "fax_number": "606-886-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 S FRONT AVE",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416531614",
            "telephone_number": "606-886-8572",
            "fax_number": "606-886-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "RONETTA",
        "middle_name": "A.",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "0371",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "270486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prestonsburg, KY

Sources for this page

Verify at the official NPI Registry.