Individual provider Active NPI

Michael David Tucker, MA, LMHC

  • Mental Health Counselor
  • Vancouver, WA
National Provider Identifier
1699073783
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH60690137 Issued in WA
Practice address
1607 Officers Row
Vancouver, WA 98661-3862
Phone
(971) 266-1934
Fax
(971) 403-0389
NPI assigned
Mar 14, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Professional Counselor 101YP2500X C4816 OR
Mental Health Counselor 101YM0800X LH60690137 WA Primary

Addresses

Primary practice location

1607 Officers Row
Vancouver, WA 98661-3862

Mailing address

1607 Officers Row
Vancouver, WA 98661-3862
Phone (971) 266-1934

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LH60690137WAMDMental Health Counselor
C4816ORMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Michael Tucker Counseling LLC CurrentSince Nov 24, 2024 Accepting new patients
Children'S Home Society of Washington Past Accepting new patients

Locations

1607 Officers Row
Vancouver, WA 98661
Phone (971) 266-1934

Organizations & group practices 2

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": "1300060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1699073783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 OFFICERS ROW",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986613862",
            "telephone_number": "971-266-1934",
            "fax_number": "971-403-0389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 OFFICERS ROW",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986613862",
            "telephone_number": "971-266-1934",
            "fax_number": "971-403-0389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "credential": "MA, LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-14",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C4816",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60690137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.