Kaitlyn Pamela Tucker

Primary specialty

CounselorTaxonomy code 101Y00000X

License

S.2309437 Issued in OH

Practice address

111 S Byrne Rd
Toledo, OH 43615-6212

Phone

(419) 531-5544

NPI assigned

Jul 17, 2023

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Philio, Inc.

  • Community/Behavioral Health Agency
  • Toledo, OH
  • NPI 1124367545
  NPD
• Philio, Inc.

  • Community/Behavioral Health Agency
  • Toledo, OH
  • NPI 1528124567
  NPD

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

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1821777822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S BYRNE RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436156212",
            "telephone_number": "419-531-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S BYRNE RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436156212",
            "telephone_number": "419-531-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "KAITLYN",
        "middle_name": "PAMELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-17",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "S.2309437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COUNSELOR, SOCIAL WORKER & MFT BOARD",
            "identifier": "S.2309437",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gwendolyn Rita Tucker, PCA
• Hortense Tucker
• Jasmine B Tucker
• Jennifer Sue Tucker, LSW
• Jessica Marie Tucker, RN
• Karen J Tucker, RN
• Kelsey Tucker
• Martin Tucker
• Mary Patricia Tucker
• Melinda Tucker, APRN, CNP

• Counselor in Toledo, OH
• Providers in Toledo, OH by specialty
• Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; 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.