Alicia Ann Puckett, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-16-25713 Issued in KY

Practice address

1109 Pawnee Dr
Elizabethtown, KY 42701-2019

Phone

(502) 705-4221

NPI assigned

Dec 29, 2017

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

Other names 1

• Alicia A West Former name

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": "1514505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1235646258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 PAWNEE DR",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012019",
            "telephone_number": "502-705-4221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 PAWNEE DR",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012019",
            "telephone_number": "502-705-4221"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "171 Twin Lakes Dr",
            "address_purpose": "LOCATION",
            "city": "Vine Grove",
            "state": "KY",
            "postal_code": "401758412",
            "country_code": "US",
            "telephone_number": "270-505-5067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUCKETT",
        "first_name": "ALICIA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-29",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "KY",
            "license": "RBT-16-25713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "WEST",
            "middle_name": "A",
            "credential": "RBT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Behavior Technician in Elizabethtown, KY
• Providers in Elizabethtown, KY by specialty
• Behavior Technician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; 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.