JEANNIE REBECCA TUCKER (NPI# 1891942975) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891942975 |
| Entity Type | Individual |
| Full Name | JEANNIE REBECCA TUCKER |
| Credential | LCSW |
| Practice Address |
233 N Main Portland AR 71663 |
| Mailing Address |
778 Scogin Dr Monticello AR 71655-5729 |
| Practice Telephone | 8607372221 |
| Practice Fax Number | 8707374337 |
| Mailing Telephone | 8705385414 |
| Mailing Fax Number | 8705385412 |
| Enumeration Date | 2008-08-20 |
| Last Update Date | 2018-10-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
5956-C | AR | Behavioral Health & Social Service Providers |
| Street Address |
233 N MAIN |
| City | PORTLAND |
| State | AR |
| Zip Code | 71663 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396074886 | Amy Floyd | Social Worker | 233 North Main, Portland, AR 71663 | 2009-12-14 |
| 1578770582 | Portland Drug Inc. | Pharmacy | 105 Hwy 165 South, Portland, AR 71663 | 2007-05-17 |
| 1316106388 | Mainline Health Systems Inc | Clinic/Center | 233 N Main St, Portland, AR 71663 | 2008-06-05 |
| 1942611504 | Portland Drug LLC | Pharmacy | 105 Hwy 65 South, Portland, AR 71663-0000 | 2014-05-16 |
| 1982128096 | Myra Brooke Flemister | Nurse Practitioner | 233 N Main St, Portland, AR 71663-9230 | 2017-07-31 |
| 1376841247 | Byron K Montgomery | Nurse Practitioner | 233 N Main St, Portland, AR 71663-9230 | 2011-03-02 |
| 1649636986 | Mainline Health Systems, Inc | Clinic/Center | 314 Highway 160 E, Portland, AR 71663-9262 | 2015-12-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063013712 | Gabriel Henriques | Massage Therapist | 805 Se Peacock Ln, Portland, OR 97214-3278 | 2020-11-07 |
| 1669073490 | Krista Marie Obenlock | Acupuncturist | 2408 N Baldwin St, Portland, OR 97217-6404 | 2020-11-06 |
| 1265033088 | Palms Residential Care | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1500 Forest Ave Apt 13d, Portland, ME 04103-1846 | 2020-11-06 |
| 1104427160 | Kristine Lee Jones | Counselor | 2628 Se 87th Ave, Portland, OR 97266-1530 | 2020-11-05 |
| 1356942221 | Joseph Cody Brainard | Physical Therapist | 4416 Ne Simpson St, Portland, OR 97218-1446 | 2020-11-05 |
| 1427659671 | Lindsay Marie Thomas | Doula | 4503 Se 66th Ave, Portland, OR 97206-4501 | 2020-11-04 |
| 1487255576 | Thomas Roy Hooks | Peer Specialist | 1221 Sw 11th Ave Apt 102, Portland, OR 97205-2143 | 2020-11-04 |
| 1063013373 | Ruth Tessema | Counselor | 2120 Ne 166th Dr, Portland, OR 97230-5558 | 2020-11-03 |
| 1598366064 | Felipe Gregorio Flores | Dentist | 107 Shorecliff Dr, Portland, TX 78374-1459 | 2020-11-02 |
| 1982204509 | Uchendu Ezra Iwuanyanwu | Occupational Therapy Assistant | 3550 S Bond Ave, Portland, OR 97239-4507 | 2020-11-01 |
| Find all providers in PORTLAND | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063012649 | Kathleen Russell | Social Worker | 7700 Sw Garden Home Rd Apt 23, Portland, OR 97223-7496 | 2020-10-31 |
| 1275131534 | Alice Hacker | Social Worker | 14702 Se Rhone St, Portland, OR 97236-2557 | 2020-10-09 |
| 1598372070 | Kristin Elizabeth Hajny | Social Worker | 9343 Sw Camille Ter, Portland, OR 97223-7042 | 2020-09-28 |
| 1821605759 | Melanie Smith | Social Worker | 4210 N Juneau St, Portland, OR 97203-2063 | 2020-09-24 |
| 1871100867 | Purely Spirit Holistic Health, LLC | Social Worker | 226 Stevens Ave Apt 9, Portland, ME 04102-2263 | 2020-09-24 |
| 1023624780 | Flourish Counseling and Consulting LLC | Social Worker | 8401 Ne Halsey St Ste 107, Portland, OR 97220-5670 | 2020-09-18 |
| 1245845130 | Crescent Psychotherapy | Social Worker | 168 Neal St, Portland, ME 04102-3343 | 2020-09-09 |
| 1861007676 | Yvonne Recchia | Social Worker | 5257 Ne Mlk, Portland, OR 97211-3282 | 2020-09-09 |
| 1447864327 | Gordon Keepers | Social Worker | 3181 Sw Sam Jackson Park Rd # Uhs8-l, Portland, OR 97239-3098 | 2020-09-08 |
| 1609484187 | Julie Pratt | Social Worker | 14 Culver Ln, Portland, CT 06480-1323 | 2020-07-21 |
| Find all providers in PORTLAND | ||||
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| 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.