Healthcare Provider Details

I. General information

NPI: 1467122531
Provider Name (Legal Business Name): SILKYA DENAI PUCKETT LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2021
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 HOGBACK RD STE 17
ANN ARBOR MI
48105-9736
US

IV. Provider business mailing address

2222 S CRAWFORD RD APT E13
MOUNT PLEASANT MI
48858-9353
US

V. Phone/Fax

Practice location:
  • Phone: 734-956-0051
  • Fax: 888-976-6019
Mailing address:
  • Phone: 734-330-1082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401225117
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: