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FREDRICK JASON TACKETT APS.004051
NPI 1235820051
Peer Specialist in Coal Grove, OH

Active since May 15, 2023
323 MARION PIKE STE 1, COAL GROVE, OH 45638(740) 237-4981(877) 325-2816 Get Directions Write a Review

NPPES record last updated: June 12, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 12, 2023, May 15, 2023 (2 updates tracked since 2023).

About Fredrick Jason Tackett Aps.004051 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FREDRICK JASON TACKETT APS.004051 (NPI 1235820051) is an individual peer specialist in Coal Grove, Ohio and active in the NPI registry since May 2023.

NPPES Registry Identity

NPI1235820051
Entity TypeIndividualMale
Primary Taxonomy175T00000X
Provider Legal NameFREDRICK JASON TACKETTCredential: APS.004051
Location Address323 MARION PIKE STE 1Coal Grove, OH 45638-2958
Mailing Address117 N 4th StIronton, OH 45638-1403 · (740) 442-7016 · Fax (877) 325-2816
Phone(740) 237-4981
Fax(877) 325-2816
Sole ProprietorYes
Enumeration DateMay 15, 2023
Last NPPES UpdateJune 12, 20232 updates tracked since enumeration
NPPES CertifiedJune 12, 2023
✔ NPI 1235820051 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X
323 MARION PIKE STE 1, Coal Grove, OH 45638
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Other Identifiers 1

Medicaid0017298OH

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RANDY WAYNE CABLE II LISW, LICDC, PRS
Social Worker (Clinical)
323 MARION PIKE STE 1
COAL GROVE, OH 45638
Lawrence County (740) 237-4981
KYLE STEVAN BLACK
Case Manager/Care Coordinator
323 MARION PIKE STE 1
COAL GROVE, OH 45638
Lawrence County (740) 237-4981
COURTNEY GALLION
Counselor (Addiction (Substance Use Disorder))
323 MARION PIKE STE 1
COAL GROVE, OH 45638
Lawrence County (740) 237-4981
AMBER ARMS CDCA
Counselor (Addiction (Substance Use Disorder))
323 MARION PIKE STE 1
COAL GROVE, OH 45638
Lawrence County (740) 237-4981
EMILY CHRISTIAN CDCA.184182
Counselor (Addiction (Substance Use Disorder))
323 MARION PIKE STE 1
COAL GROVE, OH 45638
Lawrence County (740) 237-4981
ELIZABETH CLIFT PRS
Peer Specialist
323 MARION PIKE STE 1
COAL GROVE, OH 45638
Lawrence County (740) 237-4981
ELIZABETH MAINS LICDC-CS.162074
Counselor (Addiction (Substance Use Disorder))
323 MARION PIKE STE 1
COAL GROVE, OH 45638
Lawrence County (740) 237-4981
ALLZIA JOSEPH POLLOCK CDCA.177271
Counselor (Addiction (Substance Use Disorder))
323 MARION PIKE STE 1
COAL GROVE, OH 45638
Lawrence County (740) 237-4981

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fredrick Tackett's NPI number?

The NPI number for Fredrick Tackett is 1235820051. It was assigned to this individual provider in the NPPES registry on May 15, 2023.

Where is Fredrick Tackett located?

Fredrick Tackett practices at 323 Marion Pike Ste 1, Coal Grove, OH 45638. The listed phone number is (740) 237-4981.

What is Fredrick Tackett's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Fredrick Tackett was last updated on June 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.