| Walter Tucker, MS, LPC, NCC, BHP | |
|
2100 E 8th, Douglas, AZ 85607 | |
| (520) 266-3304 | |
| Not Available |
| Full Name | Walter Tucker |
|---|---|
| Gender | Male |
| Speciality | Counselor - Professional |
| Location | 2100 E 8th, Douglas, Arizona |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609279108 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LPC-14619 (Arizona) | Primary |
| Entity Name | Community Intervention Associates Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518250620 PECOS PAC ID: 4880851971 Enrollment ID: O20120201000213 |
| Mailing Address | Practice Location Address |
|---|---|
| Walter Tucker, MS, LPC, NCC, BHP 2100 E 8th St, Douglas, AZ 85607-3544 Ph: (520) 266-3304 | Walter Tucker, MS, LPC, NCC, BHP 2100 E 8th, Douglas, AZ 85607 Ph: (520) 266-3304 |
Mrs. Betty Lynn Spering, LISAC, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 1701 N Douglas Ave, Douglas, AZ 85607 Phone: 520-364-1286 Fax: 520-805-1221 | |
Larry Corrales, Counselor Medicare: Medicare Enrolled Practice Location: 1100 N F Ave, Douglas, AZ 85607 Phone: 520-364-3285 Fax: 520-364-3378 | |
Natividad Cano, AGS, LISAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1701 N Douglas Ave, Douglas, AZ 85607 Phone: 520-364-1286 Fax: 520-805-1221 | |
Mr. Carlos G Quijada Sr., MS, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1701 N Douglas Ave, Douglas, AZ 85607 Phone: 520-366-3133 Fax: 520-364-2770 | |
Ms. Colleen Kay Mattson, MA, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1701 N Douglas Ave, Douglas, AZ 85607 Phone: 520-364-1286 Fax: 520-805-1221 | |
Vicki J French, LISAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1100 F Ave, Douglas, AZ 85607 Phone: 520-364-3285 Fax: 520-364-4261 |