Individual
MRS. ALLISON MOORE TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LCAS
Contact information
Practice address
1977 J N PEASE PL STE 104, CHARLOTTE, NC 28262-4528
(704) 503-3535
(704) 593-5555
Mailing address
118 7TH ST, CRAMERTON, NC 28032-1528
(704) 860-3386
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1347
NC
1041C0700X
Clinical Social Worker
Primary
C006500
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
147KA
BLUECROSS BLUESHIELD
NC
05
—
6112060
—
NC
Enumeration date
07/03/2007
Last updated
12/17/2009
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