Jeannie Rebecca Tucker, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

5956-C Issued in AR

Practice address

790 Roberts Dr
Monticello, AR 71655-5723

Phone

(870) 367-2461

Fax

(870) 460-6133

NPI assigned

Aug 20, 2008

Last updated

Aug 13, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

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 1

Specialty

Clinical Social Worker

Education

Other, 2007

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Delta Counseling Associates Inc

  • Community/Behavioral Health Agency
  • Monticello, AR
  • NPI 1053364612
  Medicare reassignment NPD
• Brightside Medical of Michigan PC

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1144800350

  AR

  Medicare reassignment NPD

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

{
    "created_epoch": "1219190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1891942975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 SPRING BRANCH DR",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716553849",
            "telephone_number": "870-723-1404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 ROBERTS DR",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716555723",
            "telephone_number": "870-367-2461",
            "fax_number": "870-460-6133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "JEANNIE",
        "middle_name": "REBECCA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-20",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "5956-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrie Toth
• Racheal Jordan Trantham, QBHP
• Jalisha Traver
• Audra Evan Tubbs
• Brooke Tucker
• Christal Michelle Turner, MHPP
• Juanita B Turner, LMSW
• Lindsey Ray Tyson, PT
• University of Arkansas at Monticello (UAM Sports Medicine)
• Vera Lloyd Presbyterian Family Services, Inc.

• Clinical Social Worker in Monticello, AR
• Providers in Monticello, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.