Healthcare Provider Details

I. General information

NPI: 1407585177
Provider Name (Legal Business Name): MEGAN J TUCKER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2022
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 SW B ST
ANTLERS OK
74523-3824
US

IV. Provider business mailing address

708 N STEWART AVE
NORMAN OK
73071-6232
US

V. Phone/Fax

Practice location:
  • Phone: 590-298-3001
  • Fax:
Mailing address:
  • Phone: 405-464-6060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number11326
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: