Active NPI
Tairon Tucker
- Mental Health Counselor
- Riverdale, GA
National Provider Identifier
1295345221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 305 Brookview Dr
Riverdale, GA 30274-7205 - Phone
- (347) 582-7242
- NPI assigned
- Aug 4, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
305 Brookview Dr
Riverdale, GA 30274-7205
Mailing address
305 Brookview Dr
Riverdale, GA 30274-7205
Phone (347) 582-7242
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Tairontuckerllc@gmail.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596499200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596499200000",
"number": "1295345221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 BROOKVIEW DR",
"city": "RIVERDALE",
"state": "GA",
"postal_code": "302747205",
"telephone_number": "347-582-7242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 BROOKVIEW DR",
"city": "RIVERDALE",
"state": "GA",
"postal_code": "302747205",
"telephone_number": "347-582-7242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUCKER",
"first_name": "TAIRON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-08-04",
"last_updated": "2020-08-04",
"certification_date": "2020-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Tairontuckerllc@gmail.com",
"affiliation": "N",
"address_1": "305 Brookview Dr",
"city": "Riverdale",
"state": "GA",
"country_code": "US",
"postal_code": "302747205",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Riverdale, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.