Active NPI
Gabrielle Puka
- Mental Health Counselor
- Lorain, OH
National Provider Identifier
1538714654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- C.2304912-TRNE
- Practice address
- 6140 S Broadway
Lorain, OH 44053-3821 - Phone
- (440) 233-7232
- Fax
- (440) 204-4315
- NPI assigned
- Aug 6, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | C.2304912-TRNE | OH | Primary |
Addresses
Primary practice location
6140 S Broadway
Lorain, OH 44053-3821
Mailing address
6140 S Broadway
Lorain, OH 44053-3821
Phone (440) 233-7232
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C.2304912-TRNE | OH | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reach Counseling Services | Past | Accepting new patients |
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/reachbh/r4/
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695859200000",
"number": "1538714654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6140 S BROADWAY",
"city": "LORAIN",
"state": "OH",
"postal_code": "440533821",
"telephone_number": "440-233-7232",
"fax_number": "440-204-4315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6140 S BROADWAY",
"city": "LORAIN",
"state": "OH",
"postal_code": "440533821",
"telephone_number": "440-233-7232",
"fax_number": "440-204-4315"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUKA",
"first_name": "GABRIELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-06",
"last_updated": "2023-09-28",
"certification_date": "2023-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "C.2304912-TRNE",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lorain, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.