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TUCKER EVAN MOODY RSA
NPI 1275300337
Counselor in Mattoon, IL

Active since December 08, 2023
750 BROADWAY AVE E, MATTOON, IL 61938(217) 238-5735 Get Directions Write a Review

NPPES record last updated: December 8, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Tucker Evan Moody Rsa NPPES

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

TUCKER EVAN MOODY RSA (NPI 1275300337) is an individual counselor in Mattoon, Illinois and active in the NPI registry since December 2023.

NPPES Registry Identity

NPI1275300337
Entity TypeIndividualMale
Primary Taxonomy101Y00000X
Provider Legal NameTUCKER EVAN MOODYCredential: RSA
Location Address750 BROADWAY AVE EMattoon, IL 61938-4610
Mailing Address750 Broadway Ave EMattoon, IL 61938-4610 · (217) 238-5735
Phone(217) 238-5735
Sole ProprietorNo
Enumeration DateDecember 8, 2023
NPPES CertifiedDecember 8, 2023
✔ NPI 1275300337 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
750 BROADWAY AVE E, Mattoon, IL 61938
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Other Names 1

Former Name (1)Tucker Kaczmarek

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.

KIAYA LOY MS, MHP
Counselor
750 BROADWAY AVE E
MATTOON, IL 61938
Coles County (217) 238-5700
NERISSA JONES BA
Counselor (Mental Health)
750 BROADWAY AVE E
MATTOON, IL 61938
Coles County (217) 238-5735
JESSICA MILBURN LCPC
Counselor (Professional)
750 BROADWAY AVE E
MATTOON, IL 61938
Coles County (217) 238-5700
TAYLOR DOWNEY MS
Counselor (Mental Health)
750 BROADWAY AVE E
MATTOON, IL 61938
Coles County (217) 238-5700
ALLEN M. CREAMEAN B.S.
Counselor (Mental Health)
750 BROADWAY AVE E
MATTOON, IL 61938
Coles County (217) 238-5700
MADELEINE STONE
Counselor (Mental Health)
750 BROADWAY AVE E
MATTOON, IL 61938
Coles County (217) 238-5700
AMY KIRKMAN
Counselor (Mental Health)
750 BROADWAY AVE E
MATTOON, IL 61938
Coles County (217) 238-5700
DANIELLE NEWCOMER
Counselor (Mental Health)
750 BROADWAY AVE E
MATTOON, IL 61938
Coles County (217) 238-5700

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 Tucker Moody's NPI number?

The NPI number for Tucker Moody is 1275300337. It was assigned to this individual provider in the NPPES registry on December 8, 2023. The provider is also known as Tucker Kaczmarek.

Where is Tucker Moody located?

Tucker Moody practices at 750 Broadway Ave E, Mattoon, IL 61938. The listed phone number is (217) 238-5735.

What is Tucker Moody's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

When was this NPI record last updated?

The NPPES record for Tucker Moody was last updated on December 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.