Tina Hacker, IMFT, LMFT, LICDC,

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

310432 Issued in KY

Practice address

31 Hideaway Dr
Covington, KY 41017-9775

Phone

(859) 307-4540

NPI assigned

Oct 26, 2020

Last updated

Sep 14, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Marriage and Family Therapist

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Affect Therapeutics Inc

  dba Affect Therapeutics

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Charlottesville, VA
  • NPI 1104402064

  Addiction (Substance Use Disorder), OH

  Medicare reassignment NPD
• Phoenix Bloom Family Foundation, Inc.

  • Marriage & Family Therapist
  • Covington, KY
  • NPI 1013820992
  Authorized official Same address or phone
• Phoenix Bloom Therapeutics, LLC

  • Marriage & Family Therapist
  • Covington, KY
  • NPI 1700797370
  Authorized official Same address or phone
• Affect Therapeutics, Inc.

  • Adult Mental Health Clinic/Center
  • Athens, OH
  • NPI 1528878832
  NPD

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

{
    "created_epoch": "1603670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789344000000",
    "number": "1235738741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 HIDEAWAY DR",
            "city": "COVINGTON",
            "state": "KY",
            "postal_code": "410179775",
            "telephone_number": "859-307-4540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 HIDEAWAY DR",
            "city": "COVINGTON",
            "state": "KY",
            "postal_code": "410179775",
            "telephone_number": "859-307-4540"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 S Main Cross St",
            "address_purpose": "LOCATION",
            "city": "Louisa",
            "state": "KY",
            "postal_code": "412301065",
            "country_code": "US",
            "telephone_number": "606-638-0938",
            "fax_number": "859-813-5394",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1750 Granville Pike",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "OH",
            "postal_code": "431301041",
            "country_code": "US",
            "telephone_number": "833-510-4357",
            "fax_number": "866-460-2997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HACKER",
        "first_name": "TINA",
        "name_prefix": "Ms.",
        "credential": "IMFT, LMFT, LICDC,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-26",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.162615",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "262182",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KY",
            "license": "310432",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OH",
            "license": "F.2600629",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Grupy, LCSW
• Nancy Kay Gudgeon, RN
• Patricia A. Gunning, LCSW
• Kimberly M Guy, LCSW
• Marcha Marie Gyarmati, APRN
• Shelly M Hackett, LMT
• Lori Haggard, LISW
• Jennifer Marie Haigis, APRN
• Dashia N Hall
• Racheal Marie Hamel, DDS

• Marriage & Family Therapist in Covington, KY
• Providers in Covington, KY by specialty
• Marriage & Family Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.