Justin Puch, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2014027182 Issued in MO

Practice address

200 NE Missouri Rd Ste 200
Lees Summit, MO 64086-4722

Phone

(816) 200-0390

NPI assigned

Aug 12, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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.

• Summit Ridge Counseling Group, Inc

  • Mental Health Counselor
  • Lees Summit, MO
  • NPI 1942810403
  NPD Authorized official

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

{
    "created_epoch": "1407801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1306255567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 SE 6TH TER",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640631009",
            "telephone_number": "816-729-1836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NE MISSOURI RD STE 200",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640864722",
            "telephone_number": "816-200-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCH",
        "first_name": "JUSTIN",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-12",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MO",
            "license": "6513",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2014027182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Prudden, AUD
• Rochelle Kaye Pruett, M.A., PLPC, NCC
• Deborah Pryde, PFT, MPT
• Grace C Przekurat, FNP
• Psychpros of Kansas City
• Kristen Nichole Pucket, PTA
• Sherry Ann Purvis, PT, BSPT
• Connie Mae Putthoff, LSCSW
• Azhin O Qadir, PHARMD
• Darren B Quaile, P.A.-C.

• Professional Counselor in Lees Summit, MO
• Providers in Lees Summit, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.