MEDICARE: RAANNA TUCKER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	39005811A	IN

General Provider Information

NPI Number	:	1184588550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAANNA TUCKER

Provider Business Mailing Address
First Line	:	8344 LISMORE EAST DR APT D
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-9329
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7855 S EMERSON AVE STE H
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46237-8669
Country	:	US
Telephone Number	:	317-801-3737
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/10/2025
Last Update Date	:	12/10/2025

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Directions to “ RAANNA TUCKER ” Practice Location

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