Provider Demographics
NPI:1609758093
Name:TUCKER, MACKENZIE LEIGH (NCC)
Entity type:Individual
Prefix:MS
First Name:MACKENZIE
Middle Name:LEIGH
Last Name:TUCKER
Suffix:
Gender:F
Credentials:NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7410 HONESTY WAY
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-5550
Mailing Address - Country:US
Mailing Address - Phone:301-801-8455
Mailing Address - Fax:
Practice Address - Street 1:5970 FREDERICK CROSSING LN STE 100
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21704-5176
Practice Address - Country:US
Practice Address - Phone:240-415-8893
Practice Address - Fax:240-466-1993
Is Sole Proprietor?:No
Enumeration Date:2025-07-24
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health