Danielle Elizabeth Tucker, ADULT PEER SUPPORT

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

T99251564 Issued in KY

Practice address

1439 S Brook St Apt 4
Louisville, KY 40208-2043

Phone

(502) 684-1371

NPI assigned

Apr 11, 2022

Sex

Female

Sole proprietor

Yes

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.

• Living for a Change Support Services & Residence LLC

  • Community/Behavioral Health Agency
  • Louisville, KY
  • NPI 1982319448
  NPD Authorized official

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

{
    "created_epoch": "1649635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1285376103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1439 S BROOK ST APT 4",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402082043",
            "telephone_number": "502-684-1371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1439 S BROOK ST APT 4",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402082043",
            "telephone_number": "502-684-1371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "DANIELLE",
        "middle_name": "ELIZABETH",
        "credential": "ADULT PEER SUPPORT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-11",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": "KY",
            "license": "T99251564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine Ashley Tuazon, MD, PHD
• Alison Ann Tucker, M.D.
• Amber M Tucker, LMT
• Clint M Tucker, MD
• Craig L Tucker, M.D.
• Dara Tucker, NP
• Hailey Marie Tucker, MSSW
• Heather Marie Tucker, ARNP
• Jill Ann Tucker, LPCC
• Kaitlyn Diane Tucker, PA-C

• Peer Specialist in Louisville, KY
• Providers in Louisville, KY by specialty
• Peer Specialist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2022; 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.