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NPI Code Detail

MEDICARE: SARAH TUCKER PHD, LPC

MEDICARE: SARAH TUCKER PHD, LPC
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
1101YP2500XProfessional CounselorTX

General Provider Information

NPI Number : 1245890599
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH TUCKER PHD, LPC
Provider Business Mailing Address
First Line : 2449 FORT WORTH DR
Second Line :
City : DENTON
State : TX
Zip : 76205-7684
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2449 FORT WORTH DR
Second Line :
City : DENTON
State : TX
Zip : 76205-7684
Country : US
Telephone Number : 940-202-0756
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2019
Last Update Date : 07/18/2022

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