Christopher Tucker, EDD

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

5274048-6004 Issued in UT

Practice address

2825 E Cottonwood Pkwy Ste 500
Salt Lake City, UT 84121-7060

Phone

(646) 941-7645

Fax

(929) 596-7897

NPI assigned

Apr 9, 2024

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

State licenses

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

{
    "created_epoch": "1712620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1902659089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 E MONTANA VISTA LN",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841242467",
            "telephone_number": "801-541-3068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 E COTTONWOOD PKWY STE 500",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841217060",
            "telephone_number": "646-941-7645",
            "fax_number": "929-596-7897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "EDD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-09",
        "last_updated": "2024-04-09",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "5274048-6004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenny C Tuan, MD
• Victoria Pelenaise Tuaone
• Mason Tubb
• Jokesani Tubenamarua I
• Bret J Tucker, DDS
• Erin Bryar Tucker
• Jennifer Tucker
• Jennifer Lynn Tucker
• Kara Kimiko Tucker, D.P.T.
• Railey Tucker

• Mental Health Counselor in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Mental Health Counselor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.