Active NPI
Brandy Latrice Pugh
- Counseling Psychologist
- Muncie, IN
National Provider Identifier
1710500574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- Practice address
- 3700 W Kilgore Ave
Muncie, IN 47304-4810 - Phone
- (765) 289-5437
- NPI assigned
- May 27, 2020
- 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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | Primary |
Addresses
Primary practice location
3700 W Kilgore Ave
Muncie, IN 47304-4810
Mailing address
3015 W Bethel Ave Apt 32
Muncie, IN 47304-2580
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590537600000",
"number": "1710500574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3015 W BETHEL AVE APT 32",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473042580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3700 W KILGORE AVE",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473044810",
"telephone_number": "765-289-5437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUGH",
"first_name": "BRANDY",
"middle_name": "LATRICE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-27",
"last_updated": "2020-05-27",
"certification_date": "2020-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Muncie, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.