Jerry Lloyd Tackett, IMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1145 12TH St
Vero Beach, FL 32960-3718

Phone

(772) 559-8673

Fax

(772) 562-9451

NPI assigned

Apr 18, 2007

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

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.

• Florida Senior Care Services, LLC

  • Community/Behavioral Health Agency
  • Vero Beach, FL
  • NPI 1982880688
  NPD (past) Authorized official

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649496399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 691114",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329691114",
            "telephone_number": "772-559-8673",
            "fax_number": "772-562-9451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 12TH ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329603718",
            "telephone_number": "772-559-8673",
            "fax_number": "772-562-9451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACKETT",
        "first_name": "JERRY",
        "middle_name": "LLOYD",
        "name_prefix": "Mr.",
        "credential": "IMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gretchen Szentirmai, PT
• T&T Senior Care, Inc (Seniors Helping Seniors)
• Jessica Dabi Tabuga
• Carl Tack, MD
• Robert Matthew Tack, PA-C
• Tactical Rehabilitation Inc
• Maha Tadrous
• Taher Husainy MD
• Take Flight Counseling & Consulting, LLC
• Takisha Stringer LLC (Dunamis Greater Solutions)

• Mental Health Counselor in Vero Beach, FL
• Providers in Vero Beach, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.