Jack Pullins, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC-16329 Issued in AZ

Practice address

111 S Cortez St
Prescott, AZ 86303-4703

Phone

(928) 756-9083

NPI assigned

Mar 7, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1520380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1134621964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S CORTEZ ST",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863034703",
            "telephone_number": "928-756-9083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S CORTEZ ST",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863034703",
            "telephone_number": "928-756-9083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULLINS",
        "first_name": "JACK",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-07",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LPC-16329",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AZ",
            "license": "LPC-16329",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sharon Kay Pullins, P.T.
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• Laura Pursell, RN
• Ajith Purush, MBBS, MD
• PWC II

• Mental Health Counselor in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2021; 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.