Organization Active NPI

Sandra K. Tucker, Ms, LMHC, LLC

  • Mental Health Counselor
  • Bloomington, IN
National Provider Identifier
1235695867
Registry record updated Feb 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
SANDRA K. TUCKER, MS, LMHC, LLC
Practice address
822 W 1St St Ste 4
Bloomington, IN 47403-2382
Phone
(812) 219-4918
NPI assigned
Feb 19, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2019

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

Authorized official

Name
Sandy K. Tucker, LMHC, RPTNPI 1952590812
Title
Owner
Phone
(812) 219-4918

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

822 W 1St St Ste 4
Bloomington, IN 47403-2382

Mailing address

822 W 1St St Ste 4
Bloomington, IN 47403-2382
Phone (812) 219-4918

Other names 1

  • Counselor Other name

National Provider Directory

National Provider Directory

Locations

822 W 1st St
Ste 4
Bloomington, IN 47403
Phone (812) 219-4918

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1550534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550534400000",
    "number": "1235695867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 W 1ST ST STE 4",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032382",
            "telephone_number": "812-219-4918",
            "fax_number": "888-544-9038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 W 1ST ST STE 4",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032382",
            "telephone_number": "812-219-4918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDRA K. TUCKER, MS, LMHC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-19",
        "last_updated": "2019-02-19",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "SANDY",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-219-4918",
        "authorized_official_credential": "LMHC, RPT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Counselor",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.

Verify at the official NPI Registry.