Provider Demographics
NPI:1841786357
Name:TUCKER, ALTHEA MARCILLINA (LMSW)
Entity Type:Individual
Prefix:MISS
First Name:ALTHEA
Middle Name:MARCILLINA
Last Name:TUCKER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7606 WESTBANK EXPY STE B
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-2304
Mailing Address - Country:US
Mailing Address - Phone:504-265-0801
Mailing Address - Fax:
Practice Address - Street 1:7606 WESTBANK EXPY STE B
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-2304
Practice Address - Country:US
Practice Address - Phone:504-265-0801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health