Healthcare Provider Details

I. General information

NPI: 1851527527
Provider Name (Legal Business Name): GAIL L TUCKER LAC, PCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2009
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 1ST AVE N
GREAT FALLS MT
59401-2510
US

IV. Provider business mailing address

601 1ST AVE N
GREAT FALLS MT
59401-2510
US

V. Phone/Fax

Practice location:
  • Phone: 406-454-6973
  • Fax: 406-791-9277
Mailing address:
  • Phone: 406-454-6973
  • Fax: 406-791-9277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberBBH-LAC-LIC-64281
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberBBH-PCLC-LIC-78449
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: