Cristina Puckett, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

9805-C Issued in AR

Practice address

1401 Malvern Ave Ste 152
Hot Springs, AR 71901-6370

Phone

(501) 463-0209

NPI assigned

Dec 30, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Matters of the Mind

  • Clinical Social Worker
  • Hot Springs, AR
  • NPI 1235906553
  NPD Authorized official

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

{
    "created_epoch": "1577664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1316586001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20512",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719030512",
            "telephone_number": "501-463-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MALVERN AVE STE 152",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719016370",
            "telephone_number": "501-463-0209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCKETT",
        "first_name": "CRISTINA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-30",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AR",
            "license": "9805-M",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "9805-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "289620719",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David J Proctor, PTA
• Promed Preferred Ar Professional Corporation
• David Edwin Pruitt, M.D.,
• Mitzi G Pruitt, RNP
• Psychiatric Clinic of Hot Springs PA
• Melissa Puckett, APRN
• Roy L Puen, MD
• Laura Abigail Pumphrey, APRN
• Purely Nourished Consulting, LLC
• Jacob Michael Purifoy, DDS

• Clinical Social Worker in Hot Springs, AR
• Providers in Hot Springs, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; 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.