Brant Lee Tucker, LPC-ASSOICATE
Individual provider Active NPI Counselor · Cushing, TX
NPI 1548084965 · NPPES record last updated Nov 12, 2024
Key facts
- NPI
- 1548084965
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 95380 (TX)
- Practice address
- 2995 County Road 890
Cushing, TX 75760-4311 - Phone
- (936) 652-0243
- NPI assigned
- Nov 12, 2024
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95380 | TX | MD | Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 95380 | TX | Yes |
Addresses
Primary practice location
2995 County Road 890
Cushing, TX 75760-4311
Mailing address
2995 County Road 890
Cushing, TX 75760-4311
Phone (936) 652-0243
Other providers in Cushing, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.