Provider Demographics
NPI:1518071554
Name:TINCHER, VIVIEN WATTS (MS, LPC, CDCII, MAC,)
Entity Type:Individual
Prefix:MRS
First Name:VIVIEN
Middle Name:WATTS
Last Name:TINCHER
Suffix:
Gender:F
Credentials:MS, LPC, CDCII, MAC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18708 MAN-O-WAR ROAD
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577
Mailing Address - Country:US
Mailing Address - Phone:907-696-8462
Mailing Address - Fax:
Practice Address - Street 1:10928 EAGLE RIVER RD
Practice Address - Street 2:SUITE 140
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-8038
Practice Address - Country:US
Practice Address - Phone:907-696-8462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK117101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional