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General NPI Number Information
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NPI Number | 1750702619
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Entity Type | Individual
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Provider Name | MATTHEW TUCKER LMHC
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Gender | Male
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Dates
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Enumeration Date | 12/19/2013
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Last Update Date | 04/24/2024
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Provider Practice Location Address
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Address Line | 27 WINTER ST
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City | NATICK
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State | MA
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Zip | 01760-1015
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Country | US
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Telephone | 508-655-6400
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Fax |
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Provider Business Mailing Address
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Address Line | 49 WALTHAM ST STE 2
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City | LEXINGTON
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State | MA
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Zip | 02421-5411
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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