Individual provider Active NPI

Amy Lee Tucker, LPC

  • Mental Health Counselor
  • Salem, OR
National Provider Identifier
1376059063
Registry record updated Sep 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C6918 Issued in OR
Practice address
835 Saginaw St S
Salem, OR 97302
Phone
(971) 301-4337
Fax
(971) 208-9874
NPI assigned
Dec 18, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X C6918 OR Primary

Addresses

Primary practice location

835 Saginaw St S
Salem, OR 97302

Mailing address

4589 Juliana Loop SE
Salem, OR 97317
Phone (503) 881-4561

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20240523003542 OR Practitioner - Mental Health Counselor 4082940408 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

780 Commercial St SE
Suite 304
Salem, OR 97301-3455
Phone (503) 881-4561

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C6918ORMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Psychiatric Associates, P.C. Mental Health Current Accepting new patients
Salem Psychiatric Associates PC Mental Health CurrentSince Apr 9, 2024 Accepting new patients
Wise Compass Counseling LLC Mental Health CurrentSince Dec 21, 2024 Accepting new patients
Coaction, Inc. Past Accepting new patients

Locations

780 Commercial St SE
Ste 304
Salem, OR 97301
Phone (503) 365-0045

821 Saginaw St S
Salem, OR 97302
Phone (503) 362-1999

670 Hawthorne Ave SE
Ste 150
Salem, OR 97301
Phone (503) 315-8646

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1513555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1376059063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4589 JULIANA LOOP SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97317",
            "telephone_number": "503-881-4561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 SAGINAW ST S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97302",
            "telephone_number": "971-301-4337",
            "fax_number": "971-208-9874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "AMY",
        "middle_name": "LEE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-18",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C6918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.