MEDICARE: TERRI TUCKER ROBINETTE LPC, CRC

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
1	225C00000X	Rehabilitation Counselor	00217817
2	101YP2500X	Professional Counselor	4024	AL

General Provider Information

NPI Number	:	1619647849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRI TUCKER ROBINETTE LPC, CRC

Provider Business Mailing Address
First Line	:	13 WESTERN AVE
Second Line	:
City	:	SYLACAUGA
State	:	AL
Zip	:	35150-2939
Country	:	US
Telephone Number	:	256-626-8095
Fax Number	:

Provider Business Practice Location Address
First Line	:	13 WESTERN AVE
Second Line	:
City	:	SYLACAUGA
State	:	AL
Zip	:	35150-2939
Country	:	US
Telephone Number	:	256-626-8095
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/18/2021
Last Update Date	:	09/18/2021

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