Puckett, Ritchie D

Puckett, Ritchie D is an individual health care provider with primary practice located at 847 W Lake Dr , Mount Airy NC 27030-2157. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Puckett, Ritchie D can be contacted via phone (336) 783-6919.

Contact Information

Primary practice address
847 W Lake Dr Mount Airy NC 27030-2157
Phone: (336) 783-6919
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LCAS-21887 North Carolina
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LCAS 21887 North Carolina

Profile Details

NPI number 1093198954
LBN Legal business name Puckett, Ritchie D
Credentials LCAS-A
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 9th, 2015
Last updated May 24th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1093198954 NPPES
North Carolina MEDICAID LCAS-21887

Popular Providers