Provider Demographics
NPI:1184280414
Name:TUCKER, ELIZABETH (LIBBY) ANN (LCPC)
Entity type:Individual
Prefix:
First Name:ELIZABETH (LIBBY)
Middle Name:ANN
Last Name:TUCKER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:ELIZABETH (LIBBY)
Other - Middle Name:ANN
Other - Last Name:TUCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:949 E 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-4096
Mailing Address - Country:US
Mailing Address - Phone:208-723-9474
Mailing Address - Fax:
Practice Address - Street 1:949 E 4TH AVE
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-4096
Practice Address - Country:US
Practice Address - Phone:208-723-9474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-13
Last Update Date:2025-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID8461871101YM0800X
WA61228084101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health