# MICHAEL PUCKETT

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1326763673
- **Gender:** Man

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | CDCA.188652 | OH | Yes |
| 171M00000X | Case Manager/Care Coordinator | 2022 | OH | — |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | QMHS | OH | — |

## Other

- **Enumeration date:** 10/10/2022
- **Last updated:** 07/30/2024