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Individual

CARL TUCKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA, LPCC-S, LICDC-CS

Contact information

Practice address
311 MARTIN LUTHER KING DR E, CINCINNATI, OH 45219-2581
(513) 475-5360
(513) 475-5394
Mailing address
311 MARTIN LUTHER KING DRIVE, CINCINNATI, OH 45219
(513) 475-5360
(513) 475-5394

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
84044
OH
101YM0800X
Mental Health Counselor
Primary
486
OH

Other

Enumeration date
03/09/2016
Last updated
03/09/2016
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