Active NPI
Emily Puckett, LPC
- Professional Counselor
- McDonough, GA
National Provider Identifier
1558024760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC014197
- Practice address
- 1944 Brannan Rd
McDonough, GA 30253-4310 - Phone
- (404) 304-5622
- NPI assigned
- Oct 15, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | APC008088 | GA | |
| Professional Counselor | 101YP2500X | LPC014197 | GA | Primary |
Addresses
Primary practice location
1944 Brannan Rd
McDonough, GA 30253-4310
Mailing address
50 Boardwalk Ave
Covington, GA 30016-8045
Other practice location 1
2805 Metropolitan Pkwy SW
Atlanta, GA 30315-7915
Phone (404) 304-5622
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 |
|---|---|---|---|
| APC008088 | GA | MD | Professional Counselor |
| LPC014197 | GA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eagle'S Landing Christian Counseling Center, Inc. | Professional | Past | Accepting new patients |
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.
-
- Professional Counselor
- McDonough, GA
- NPI 1093955205
Professional
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1634256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697500800000",
"number": "1558024760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 BOARDWALK AVE",
"city": "COVINGTON",
"state": "GA",
"postal_code": "300168045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1944 BRANNAN RD",
"city": "MCDONOUGH",
"state": "GA",
"postal_code": "302534310",
"telephone_number": "404-304-5622"
}
],
"practiceLocations": [
{
"address_1": "2805 Metropolitan Pkwy SW",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303157915",
"country_code": "US",
"telephone_number": "404-304-5622",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PUCKETT",
"first_name": "EMILY",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-15",
"last_updated": "2023-10-17",
"certification_date": "2023-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "APC008088",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC014197",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McDonough, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.