David C Tucker, LPC | |
465 Medical Center Parkway, Clinton, AR 72031-1529 | |
(501) 745-7888 | |
(877) 460-4576 |
Full Name | David C Tucker |
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Gender | Male |
Speciality | Counselor - Professional |
Location | 465 Medical Center Parkway, Clinton, Arkansas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1770964975 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
101YP2500X | Counselor - Professional | P2011100 (Arkansas) | Primary |
Entity Name | River Valley Medical Wellness, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1386268555 PECOS PAC ID: 7315363199 Enrollment ID: O20200812000194 |
Mailing Address | Practice Location Address |
---|---|
David C Tucker, LPC Po Box 1060, Marshall, AR 72650-1060 Ph: (870) 448-5101 | David C Tucker, LPC 465 Medical Center Parkway, Clinton, AR 72031-1529 Ph: (501) 745-7888 |
Ms. Judy Johnston, L.P.E. Counselor Medicare: Not Enrolled in Medicare Practice Location: 2526 Highway 65 S, Suite 202, Clinton, AR 72031 Phone: 501-745-4584 Fax: 501-745-5921 | |
Robin Lanae Duran, M.S. Counselor Medicare: Not Enrolled in Medicare Practice Location: 770 Yellowjacket Ln, Clinton, AR 72031 Phone: 501-365-3022 | |
Rebecca Sangi, Counselor Medicare: Not Enrolled in Medicare Practice Location: 244 U.s. 65, Suite 6, Clinton, AR 72031 Phone: 866-533-1765 Fax: 501-745-5925 | |
Amy Shaw, LAC Counselor Medicare: Medicare Enrolled Practice Location: 2526 Highway 65 S, Clinton, AR 72031 Phone: 501-745-8007 Fax: 501-745-8220 | |
Jimmy Norman Iii, Counselor Medicare: Not Enrolled in Medicare Practice Location: 242 Shake Rag Rd, Clinton, AR 72031 Phone: 501-303-3105 | |
Mrs. Shelly Daud, L.P.E Counselor Medicare: Not Enrolled in Medicare Practice Location: 2526 Highway 65 S, Suite 202, Clinton, AR 72031 Phone: 501-329-1329 | |
Kimberly Westbrook, Counselor Medicare: Not Enrolled in Medicare Practice Location: 242 Shake Rag Rd, Clinton, AR 72031 Phone: 501-303-3105 |