Kelly Puckett, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

108240-01 Issued in NY

Practice address

26 Court St Ste 1303
Brooklyn, NY 11242-1113

Phone

(502) 592-0602

NPI assigned

Feb 17, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 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.

• Chamin Ajjan Psychotherapy, LCSW PLLC

  • Clinical Social Worker
  • Brooklyn, NY
  • NPI 1174127153
  NPD

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

{
    "created_epoch": "1645056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1952056970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 18TH ST APT 2F",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112181130",
            "telephone_number": "502-592-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 COURT ST STE 1303",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112421113",
            "telephone_number": "502-592-0602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCKETT",
        "first_name": "KELLY",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-17",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "108240-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://chaminajjan.com/",
            "affiliation": "Y",
            "affiliationName": "Chamin Ajjan Psychotherapy, LCSW PLLC",
            "address_1": "26 Court St Ste 1303",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112421113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Francesca Pucci
• Jake Donald Pucci
• Jessica Puccio, PT, DPT
• Laura Regina Pucillo, MD
• Geetawali Puckett, LPN
• Anna Pudel, OTR/L
• Peri Puderbeutel
• Yhermana Puello
• Denise Puente
• Yolanda Puente, MSED

• Clinical Social Worker in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.