Individual
RITCHIE D PUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCAS-A
Contact information
Practice address
847 W LAKE DR, MOUNT AIRY, NC 27030-2157
(336) 783-6919
Mailing address
284 EXECUTIVE PARK DR. SUITE 100, CONCORD, NC 28025-1894
(704) 939-1100
(704) 939-1173
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS 21887
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-21887
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LCAS-21887
—
NC
Enumeration date
07/09/2015
Last updated
05/24/2017
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