Individual provider · Type 1 NPI

Juanita Tucker, QMHP

Mental Health Counselor · Portland, OR

NPI number 1114092145 Active

Practice location

3034 NE M L King Blvd
Portland, OR 97212-3053

Call (503) 283-3763 Map

Mailing address

4216 NE Rodney Ave
Portland, OR 97211-3428

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed
Addiction (Substance Use Disorder) Counselor 101YA0400XNone listed
Clinical Social Worker 1041C0700XL4517 (OR)

Mental Health Counselor: Definition to come...

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About NPI 1114092145

Juanita Tucker, QMHP's National Provider Identifier is 1114092145, issued on Nov 22, 2006. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Portland, OR. The record was last updated on Dec 21, 2012.