Healthcare Provider Details

I. General information

NPI: 1134041437
Provider Name (Legal Business Name): CAITLIN TUCKER PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8231 SUMMA AVE STE C
BATON ROUGE LA
70809-3497
US

IV. Provider business mailing address

1413 PATRICK DR
BATON ROUGE LA
70810-3039
US

V. Phone/Fax

Practice location:
  • Phone: 225-366-7449
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPLC11249
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: