| Provider / Organization | NPI | Date Certified |
|---|---|---|
| KEVIN TUCKER | 1629315916 | 2024-04-03 |
Kevin Tucker is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1629315916. Registration indicates Kevin Tucker is a provider of access to mental health/behavioral health providers services with a specialization in Behavioral Health & Social Service Providers, Counselor (Behavioral Health & Social Service Providers, Counselor) (Counselor: Professional, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Counselor Professional, Behavioral Health & Social Service Providers) (Counselor, )
| Entity Type | Individual |
| Provider Name | Kevin Tucker LPC |
| Practice Office Address | 5300 MEMORIAL DR STE 216 STONE MOUNTAIN, GA US |
| Practice Office Telephone | 6784816375 |
| Practice Office Fax | 6783487215 |
| Mailing Address | 5300 MEMORIAL DR STE 216 STONE MOUNTAIN, GA 300833134 US |
| Business Telephone | 6784816375 |
| Business Fax | 6783487215 |
| Code | Practice | License No State |
|---|---|---|
| 101YP2500X PRIMARY | Access to Mental Health/Behavioral Health Providers Behavioral Health & Social Service Providers Counselor Behavioral Health & Social Service Providers Counselor Counselor: Professional Behavioral Health/Substance Abuse/Psychiatry Counselor Professional Behavioral Health & Social Service Providers Counselor | LPC007095
GA |