Colette Purucker, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801091270 Issued in MI

Practice address

100 S Jefferson St B
Hastings, MI 49058-4905

Phone

(269) 331-0283

NPI assigned

Jul 1, 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

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Purucker Counseling Services PLLC

  • Clinical Social Worker
  • Hastings, MI
  • NPI 1215507090
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1498867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1255852091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 S CHURCH ST",
            "city": "HASTINGS",
            "state": "MI",
            "postal_code": "490582212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S JEFFERSON ST B",
            "city": "HASTINGS",
            "state": "MI",
            "postal_code": "490584905",
            "telephone_number": "269-331-0283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURUCKER",
        "first_name": "COLETTE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-01",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801091270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dikshita Poudel, MD
• Nilesh Maraj Prashad, MD
• Jacob Pratt, LLBSW
• Prevos Family Markets LLC
• Purucker Counseling Services PLLC
• Ronika Rai
• Gregory Thomas Randall, DDS
• Karlie Raphael
• Max D Rappaport, M.D.
• Kayla Reaser

• Clinical Social Worker in Hastings, MI
• Providers in Hastings, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.