Provider Demographics
NPI:1225573538
Name:TUCKER, JENNIFER LEIGH (MS, LPC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LEIGH
Last Name:TUCKER
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC, ACAS
Mailing Address - Street 1:20707 KEEGANS LEDGE LN
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-7727
Mailing Address - Country:US
Mailing Address - Phone:281-826-9171
Mailing Address - Fax:
Practice Address - Street 1:14525 FM 529 RD STE 104
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-3596
Practice Address - Country:US
Practice Address - Phone:281-826-9171
Practice Address - Fax:281-301-7799
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-21
Last Update Date:2022-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72503101Y00000X, 101YP2500X, 106H00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist