Active NPI
Phillip Michael Tucker, LPC - MHSP
- Professional Counselor
- Sevierville, TN
National Provider Identifier
1952860397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 4446
- Practice address
- 3889 Wonderland LN
Sevierville, TN 37862-8288 - Phone
- (865) 366-7218
- NPI assigned
- Mar 15, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 4446 | TN | Primary |
Addresses
Primary practice location
3889 Wonderland LN
Sevierville, TN 37862-8288
Mailing address
1514 Maury St
Alcoa, TN 37701-2028
Phone (865) 640-1782
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4446 | TN | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552608000000",
"number": "1952860397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1514 MAURY ST",
"city": "ALCOA",
"state": "TN",
"postal_code": "377012028",
"telephone_number": "865-640-1782"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3889 WONDERLAND LN",
"city": "SEVIERVILLE",
"state": "TN",
"postal_code": "378628288",
"telephone_number": "865-366-7218"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUCKER",
"first_name": "PHILLIP",
"middle_name": "MICHAEL",
"credential": "LPC - MHSP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-03-15",
"last_updated": "2019-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TN",
"license": "4446",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sevierville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.