Individual provider Active NPI

Tina Marie Tucker, LPC

  • Professional Counselor
  • Morgantown, WV
National Provider Identifier
1639771215
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2878 Issued in WV
Practice address
3602 Collins Ferry Rd
Morgantown, WV 26505-2378
Phone
(304) 598-4214
NPI assigned
Nov 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Professional Counselor 101YP2500X 2878 WV Primary

Addresses

Primary practice location

3602 Collins Ferry Rd
Morgantown, WV 26505-2378

Mailing address

90 S Pennsylvania Ave Apt C
Uniontown, PA 15401-4269
Phone (724) 562-3154

Other practice location 1

373 Burrows St
Pittsburgh, PA 15213-2201
Phone (412) 383-1550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231219002098 WV Practitioner - Mental Health Counselor 0143670091 Reassigns benefits to 1 organization
I20250326001159 PA Practitioner - Mental Health Counselor 0143670091 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2878WVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Medical Corporation CurrentSince Jan 1, 2024 Accepting new patients
Chestnut Ridge Counseling Services Inc CurrentSince Mar 1, 2025 Accepting new patients
West Virginia University Medical Corporation CurrentSince Jan 1, 2024 Accepting new patients

Locations

100 New Salem Rd
Ste 116
Uniontown, PA 15401

111 W Fayette St
Uniontown, PA 15401
Phone (724) 320-0176

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

3602 Collins Ferry Rd
Morgantown, WV 26505

Organizations & group practices 3

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": "1604966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1639771215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 S PENNSYLVANIA AVE APT C",
            "city": "UNIONTOWN",
            "state": "PA",
            "postal_code": "154014269",
            "telephone_number": "724-562-3154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3602 COLLINS FERRY RD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265052378",
            "telephone_number": "304-598-4214"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "373 Burrows St",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152132201",
            "country_code": "US",
            "telephone_number": "412-383-1550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "TINA",
        "middle_name": "MARIE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-10",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WV",
            "license": "2878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

Verify at the official NPI Registry.