MR. MICHAEL TODD PUCKETT


Address: 980 N Michigan Ave Ste 1400, Chicago, IL 60611-7500
Phone: 3122143588

MR. MICHAEL TODD PUCKETT (NPI# 1578668794) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1578668794
Entity Type Individual
Full Name MR. MICHAEL TODD PUCKETT
Credential LCPC
Practice Address 980 N Michigan Ave Ste 1400
Chicago
IL 60611-7500
Mailing Address 1340 N Astor St Apt 2305
Chicago
IL 60610-2163
Practice Telephone 3122143588
Mailing Telephone 3123996862
Enumeration Date 2006-09-13
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YM0800X Counselor
Specialization: Mental Health
IL Behavioral Health & Social Service Providers

Other Providers MICHAEL PUCKETT

NPI Name Taxonomy Address Enumeration
1639434723 Michael Christopher Puckett Psychologist 903 W Main St, Antlers, OK 74523-2045 2012-07-05
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Office Location

Street Address 980 N MICHIGAN AVE STE 1400
City CHICAGO
State IL
Zip Code 60611-7500

Providers in the same location

NPI Name Taxonomy Address Enumeration
1821438151 Leanna Fortunato Psychologist 980 N Michigan Ave Ste 1400, Chicago, IL 60611 2013-07-01
1386712255 Rachel Rubenstein Social Worker 980 N Michigan Ave Ste 1400, Chicago, IL 60611-7500 2006-12-01

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Taxonomy Information

Taxonomy Code 101YM0800X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Mental Health

Taxonomy Definition

Definition to come...

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Competitor

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City CHICAGO
Zip Code 60611

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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