Active NPI
Loretta Puckett, LPCC, LCADC, NCC
- Professional Counselor
- Louisville, KY
National Provider Identifier
1972968378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 165137
- Practice address
- 3215 Fern Valley Rd
Suite 202
Louisville, KY 40213-3552 - Phone
- (502) 554-0975
- NPI assigned
- Dec 29, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 165137 | KY | Primary |
Addresses
Primary practice location
3215 Fern Valley Rd
Suite 202
Louisville, KY 40213-3552
Mailing address
3215 Fern Valley Rd
Suite 202
Louisville, KY 40213-3552
Phone (502) 936-4905
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 |
|---|---|---|---|
| 165137 | KY | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1451347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474243200000",
"number": "1972968378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3215 FERN VALLEY RD",
"address_2": "SUITE 202",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402133552",
"telephone_number": "502-936-4905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3215 FERN VALLEY RD",
"address_2": "SUITE 202",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402133552",
"telephone_number": "502-554-0975"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUCKETT",
"first_name": "LORETTA",
"credential": "LPCC, LCADC, NCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-12-29",
"last_updated": "2016-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "KY",
"license": "165137",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.