MEDICARE: JILL AHRENS TUCKER M.ED., LPC-S

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	101YP2500X	Professional Counselor	61830	TX
2	101Y00000X	Counselor	61830	TX

General Provider Information

NPI Number	:	1982932968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILL AHRENS TUCKER M.ED., LPC-S

Provider Business Mailing Address
First Line	:	637 W 18TH ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-3609
Country	:	US
Telephone Number	:	713-446-2819
Fax Number	:

Provider Business Practice Location Address
First Line	:	637 W 18TH ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-3609
Country	:	US
Telephone Number	:	713-352-7789
Fax Number	:

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

Provider Enumeration Date	:	12/02/2009
Last Update Date	:	08/20/2021

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Directions to “ JILL AHRENS TUCKER M.ED., LPC-S” Practice Location

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