MR. KENNETH S TUCKER


Address: 1956 Ne 5th Ave, Suite 7, Boca Raton, FL 33431-7772
Phone: 5612395618

MR. KENNETH S TUCKER (NPI# 1861402596) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1861402596
Entity Type Individual
Full Name MR. KENNETH S TUCKER
Credential LMHC
Practice Address 1956 Ne 5th Ave
Suite 7
Boca Raton
FL 33431-7772
Mailing Address Po Box 880627
Boca Raton
FL 33488-0627
Practice Telephone 5612395618
Practice Fax Number 5614837231
Mailing Telephone 5612395618
Mailing Fax Number 5614837231
Enumeration Date 2006-08-08
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YM0800X Counselor
Specialization: Mental Health
LMHC0000442 FL Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
FL FLORIDA BLUE CROSS/BLUE S Z1058 01
FL BLUE CROSS/ BLUE SHIELD X1096 01

Other Providers KENNETH TUCKER

NPI Name Taxonomy Address Enumeration
1346518537 Kenneth Richard Tucker Plastic Surgery 22843 Tranquility Pl Ne, Kingston, WA 98346-8241 2011-12-02
1114280997 Kenneth Wayne Tucker Registered Nurse 405 E Georgia Ave, Ruston, LA 71270-3926 2012-06-18
1346294204 Kenneth B Tucker Internal Medicine 1118 Ross Clark Cir, Suite 100, Dothan, AL 36301-3001 2006-05-22
1225006430 Kenneth A Tucker Physical Therapist 711 D St, #102, San Rafael, CA 94901-3707 2006-03-14
1669479846 Kenneth Tucker Internal Medicine 11900 E 12 Mile Rd, Suite 300, Warren, MI 48093-3400 2005-07-05

Office Location

Street Address 1956 NE 5TH AVE
SUITE 7
City BOCA RATON
State FL
Zip Code 33431-7772

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NPI Name Taxonomy Address Enumeration
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Taxonomy Information

Taxonomy Code 101YM0800X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Mental Health

Taxonomy Definition

Definition to come...

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1497380695 Olga Sophia Grinfeld Counselor 751 Park of Commerce Dr Ste 128, Boca Raton, FL 33487-3623 2020-03-08
1386288629 Lisheyna S Hurvitz Counselor 22715 Camino Del Mar, # 35, Boca Raton, FL 33433 2019-10-30
1205477486 Deborah Hecker Counselor 1303 Bridgewood Dr, Boca Raton, FL 33434-4129 2019-09-30
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Competitor

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City BOCA RATON
Zip Code 33431

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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