Bre'Anna Puckett-Woods
Individual provider Active NPI Mental Health Counselor · Cairo, IL
NPI 1972050409 · NPPES record last updated Sep 1, 2016
Key facts
- NPI
- 1972050409
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 1401 Washington Ave
Cairo, IL 62914-1810 - Phone
- (618) 734-2665
- NPI assigned
- Sep 1, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healing Emotions Mental Health Services PLLC | Mental Health | Past | Accepting new patients |
Interoperability endpoints
- beanna.puckettwoods.p1@direct.chesi.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
1401 Washington Ave
Cairo, IL 62914-1810
Mailing address
1401 Washington Ave
Cairo, IL 62914-1810
Phone (618) 734-2665
Other providers in Cairo, IL
- Amir Namazi
- Glenn A Parker
- Pilot House
- Linda Poindexter
- Debra Joy Powell
- Marva Purchase
- Arlene Schoen
- James A Schwab
- Tasha Simmerman
- Sarah Sims
All providers in Cairo, IL · Mental Health Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 1, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.