Puckett Child and Family Therapy

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

PUCKETT CHILD AND FAMILY THERAPY

Practice address

490 Hwy 42 West Clayton, NC 27520
Clayton, NC, NC 27520

Phone

(919) 210-9850

NPI assigned

Apr 5, 2022

Organization subpart

No

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

Authorized official

Name

Suzanne Puckett, LCMHC

Title

Practice Owner

Phone

(919) 210-9850

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649116800000",
    "number": "1821739822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 MARY ELLEN WAY",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275208708",
            "telephone_number": "919-210-9850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 HWY 42 WEST CLAYTON, NC 27520",
            "city": "CLAYTON, NC",
            "state": "NC",
            "postal_code": "27520",
            "telephone_number": "919-210-9850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUCKETT CHILD AND FAMILY THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-04-05",
        "certification_date": "2022-03-23",
        "status": "A",
        "authorized_official_last_name": "PUCKETT",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "919-210-9850",
        "authorized_official_credential": "LCMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCBLCMHC",
            "identifier": "2688",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• North Carolina Vascular Center PLLC

• Mental Health Counselor in Clayton, NC, NC
• Providers in Clayton, NC, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; 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.