Timothy John Tucker Jr., CDCA, AA OF ARTS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CDCA167908 Issued in OH

Practice address

350 South Irwin Road
Holland, OH 43528

Phone

(567) 703-9064

NPI assigned

Sep 25, 2018

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Lima-Urban Minority Alcoholism and Drug Abuse Outreach Program., Inc

  • Community Health Clinic/Center
  • Lima, OH
  • NPI 1629144050
  NPD (past)

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

{
    "created_epoch": "1537833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537833600000",
    "number": "1235614397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 W COLLEGE AVE APT 5T",
            "city": "WOODVILLE",
            "state": "OH",
            "postal_code": "434691066",
            "telephone_number": "567-703-9064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 SOUTH IRWIN ROAD",
            "city": "HOLLAND",
            "state": "OH",
            "postal_code": "43528",
            "telephone_number": "567-703-9064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "TIMOTHY",
        "middle_name": "JOHN",
        "name_suffix": "Jr.",
        "credential": "CDCA, AA OF ARTS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-25",
        "last_updated": "2018-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA167908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Toledo Clinic Incorporated
• Toledo Spine Joint and Pain LLC
• Therese Tolland-Lavey
• Annette Tolley
• Michelle Torrence
• Lindsay Kristen Turner
• Priscilla B Turner, P.T.
• Colleen Catherine Tye, L.P.T.
• U.S. Healthworks Medical Group of Ohio, Inc.
• U.S. Healthworks Medical Group of Ohio, Inc.

• Addiction (Substance Use Disorder) Counselor in Holland, OH
• Providers in Holland, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2018; 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.