Provider Demographics
NPI:1174091276
Name:TUCKER, LASHAWN C (MED, LPC, LCDC-I)
Entity type:Individual
Prefix:MS
First Name:LASHAWN
Middle Name:C
Last Name:TUCKER
Suffix:
Gender:F
Credentials:MED, LPC, LCDC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19007 DEE WOODS DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-5042
Mailing Address - Country:US
Mailing Address - Phone:832-527-1884
Mailing Address - Fax:
Practice Address - Street 1:19007 DEE WOODS DR
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-5042
Practice Address - Country:US
Practice Address - Phone:832-527-1884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-06
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101YA0400X
TX77151101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health