WYATT TUCKER PASCO NPI 1194407528

NPI Information

  • NPI: 1194407528
  • Provider Name: WYATT TUCKER PASCO
  • Classification: Peer Specialist - 175T00000X
  • Entity Type: Individual
  • Address: 76 GIFFORD LN
    CONCORD, MA
    ZIP 01742
  • Phone: (617) 800-6697

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NPI Details

Wyatt Tucker Pasco is a peer specialist in Concord, MA. The provider is 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. Wyatt Tucker Pasco NPI is 1194407528. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

76 GIFFORD LN
CONCORD, MA
ZIP 01742-235
Phone: (617) 800-6697

The enumeration date for this NPI number is 8/4/2023 and was last updated on 8/4/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1175T00000XPeer SpecialistOREGONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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