Provider Demographics
NPI:1447747548
Name:TUCKER, SHEILA (LMFT)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:TUCKER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 PEREGRINE DR
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-2072
Mailing Address - Country:US
Mailing Address - Phone:843-384-3679
Mailing Address - Fax:
Practice Address - Street 1:200 MAIN ST STE 201H
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926-1659
Practice Address - Country:US
Practice Address - Phone:843-592-3998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-16
Last Update Date:2024-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7925106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist