Stacy Michele Puckett, M.S.,CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

4327 Issued in OK

Practice address

7787 S 425 Rd
Inola, OK 74036-5364

Phone

(918) 691-8157

NPI assigned

Aug 9, 2007

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

• Stacy Moses Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Collaborative Therapy Services Inc

  • Multi-Specialty Clinic/Center
  • Broken Arrow, OK
  • NPI 1932344835
  NPD (past)
• Today'S Therapy Solutions

  • Speech-Language Pathologist
  • Moore, OK
  • NPI 1558408450
  NPD (past)

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

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1275724635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7787 S 425 RD",
            "city": "INOLA",
            "state": "OK",
            "postal_code": "740365364",
            "telephone_number": "918-691-8157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7787 S 425 RD",
            "city": "INOLA",
            "state": "OK",
            "postal_code": "740365364",
            "telephone_number": "918-691-8157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCKETT",
        "first_name": "STACY",
        "middle_name": "MICHELE",
        "name_prefix": "Mrs.",
        "credential": "M.S.,CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-09",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "4327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "MOSES",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Medstaffpc
• Adrianne Elizabeth Morrow, RN, BSN
• Mackenzie Oxford, M.S., CCC-SLP
• Pathways to Peace Counseling, LLC
• Patterns ABA Company 1 LLC
• S. Scott Laster, D.D.S., Inc.
• Amanda M Smith
• Brian D Timmerman, RN
• Janet L. Turner, D. PH
• P. Andrew Turner, D. PH.

• Speech-Language Pathologist in Inola, OK
• Providers in Inola, OK by specialty
• Speech-Language Pathologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; 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.