Mimi Pugh, LADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1574 Issued in CT

Practice address

73 Walnut St
Manchester, CT 06040-4954

Phone

(860) 506-5765

NPI assigned

Jul 24, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Love Your Life LLC

  • Addiction (Substance Use Disorder) Counselor
  • Manchester, CT
  • NPI 1710715321
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1721779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1003644618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 HAZARD AVE # 23",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060823713",
            "telephone_number": "860-506-5765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 WALNUT ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404954",
            "telephone_number": "860-506-5765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUGH",
        "first_name": "MIMI",
        "credential": "LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-24",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "1574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prudhomme Vision LLC
• Regan Marquis Prudhomme, OD
• Sheenay Kendra Pryce, MD
• Thomas James Ptachcinski, B.S.
• Ptsma Inc
• Kenneth M Pulk
• Beth Marie Purcell, RPT
• Amy Purnell
• Takerra Purnell, LMSW
• Jamie M Putnoki

• Addiction (Substance Use Disorder) Counselor in Manchester, CT
• Providers in Manchester, CT by specialty
• Addiction (Substance Use Disorder) Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.