Active NPI
Michael David Tucker, MA, LMHC
- Mental Health Counselor
- Vancouver, WA
National Provider Identifier
1699073783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LH60690137
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| LH60690137 | WA | MD | Mental Health Counselor |
| C4816 | OR | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michael Tucker Counseling LLC | Current | 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.
-
- Community/Behavioral Health Agency
- Vancouver, WA
- NPI 1689426587
-
- Community/Behavioral Health Agency
- Vancouver, WA
- NPI 1063566867
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.