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Organization
PUCKETT CHILD AND FAMILY THERAPY
Active
Organization
PUCKETT CHILD AND FAMILY THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUZANNE PUCKETT LCMHC (PRACTICE OWNER)
(919) 210-9850
Entity
Organization
Contact information
Practice address
490 HWY 42 WEST CLAYTON, NC 27520, CLAYTON, NC, NC 27520
(919) 210-9850
Mailing address
141 MARY ELLEN WAY, CLAYTON, NC 27520-8708
(919) 210-9850
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2688
NCBLCMHC
NC
Enumeration date
04/05/2022
Last updated
04/05/2022
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