Active NPI
Marissa Elizabeth Tucker
- Behavior Analyst
- Port Saint Lucie, FL
National Provider Identifier
1306716667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-26-2849935
- Practice address
- 1801 SE Hillmoor Dr Ste B101B103
Port Saint Lucie, FL 34952-7553 - Phone
- (413) 887-7183
- NPI assigned
- Nov 10, 2025
- Reactivated
- Aug 25, 2026
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-26-2849935 | FL | Primary |
Addresses
Primary practice location
1801 SE Hillmoor Dr Ste B101B103
Port Saint Lucie, FL 34952-7553
Mailing address
525 22ND Ave
Vero Beach, FL 32962-1335
Phone (413) 887-7183
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1762732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789084800000",
"number": "1306716667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "525 22ND AVE",
"city": "VERO BEACH",
"state": "FL",
"postal_code": "329621335",
"telephone_number": "413-887-7183"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 SE HILLMOOR DR STE B101B103",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349527553",
"telephone_number": "413-887-7183"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUCKER",
"first_name": "MARISSA",
"middle_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-11-10",
"last_updated": "2026-09-11",
"certification_date": "2026-09-11",
"deactivation_date": "2026-07-30",
"reactivation_date": "2026-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "FL",
"license": "1-26-2849935",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Saint Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.