Provider Demographics
NPI:1821624172
Name:DENT, UCHER THOMAS (LPC)
Entity Type:Individual
Prefix:MRS
First Name:UCHER
Middle Name:THOMAS
Last Name:DENT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4084 PINE ST
Mailing Address - Street 2:
Mailing Address - City:OCHLOCKNEE
Mailing Address - State:GA
Mailing Address - Zip Code:31773-3214
Mailing Address - Country:US
Mailing Address - Phone:229-221-6265
Mailing Address - Fax:
Practice Address - Street 1:4084 PINE ST
Practice Address - Street 2:
Practice Address - City:OCHLOCKNEE
Practice Address - State:GA
Practice Address - Zip Code:31773-3214
Practice Address - Country:US
Practice Address - Phone:229-221-6265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-19
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC011179101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional