Ashley Danielle Tucker, MA, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC04740 Issued in MN

Practice address

4910 Constellation Dr
White Bear Lake, MN 55127-2218

Phone

(651) 243-2484

NPI assigned

Dec 16, 2024

Sex

Female

Sole proprietor

No

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

Opted out of Medicare

Yes, effective Dec 19, 2024 through Dec 19, 2026

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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.

• North Woods Christian Counseling, LLC

  • Marriage & Family Therapist
  • White Bear Lake, MN
  • NPI 1831461813

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1734307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1457168015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 234",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558010234",
            "telephone_number": "651-243-2484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 CONSTELLATION DR",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551272218",
            "telephone_number": "651-243-2484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "ASHLEY",
        "middle_name": "DANIELLE",
        "name_prefix": "Mrs.",
        "credential": "MA, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-16",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC04740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Tramm, PSYD
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• United Care Services
• United Care Services LLC
• Jessica Van Berkum
• Jordan Van Eps, PT, DPT, CSCS
• Aimee Van Ostrand

• Mental Health Counselor in White Bear Lake, MN
• Providers in White Bear Lake, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.