Jacilynn Eileen Tucker, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2017009209 Issued in MO

Practice address

1430 Olive St Ste 500
Saint Louis, MO 63103-2377

Phone

(314) 206-3700

NPI assigned

Apr 4, 2017

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

Other names 1

• Jacilynn Eileen Tucker Former name

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Mental Health Counselor

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

BJC Behavioral HealthGroup PAC ID 1153225271, shared by 2 NPIs, 63 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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.

• BJC Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saint Louis, MO
  • NPI 1669485868
  Medicare reassignment NPD
• BJC Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Farmington, MO
  • NPI 1801807847
  Medicare reassignment NPD

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

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1487187845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 OLIVE ST STE 500",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631032377",
            "telephone_number": "314-206-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 OLIVE ST STE 500",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631032377",
            "telephone_number": "314-206-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "JACILYNN",
        "middle_name": "EILEEN",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-04",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2017009209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACILYNN",
            "last_name": "TUCKER",
            "middle_name": "EILEEN",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ecenur Tuc Bengur
• Ciara Shontell Tucker
• David Tucker
• David Joseph Tucker, MD
• Derrick Tucker, LMT
• Jane L Tucker, M.D.
• Kathryn Sue Tucker
• Larry Dwitt Tucker, RPH
• Mallory Tucker
• Marissa Elaine Tucker, CRNA

• Professional Counselor in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.