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NPI Code Detail

MEDICARE: CHANELL LANEZ PURVIS

MEDICARE: CHANELL LANEZ PURVIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor0710102000VA

General Provider Information

NPI Number : 1245186253
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHANELL LANEZ PURVIS
Provider Business Mailing Address
First Line : 940 THOMAS CIR
Second Line :
City : PORTSMOUTH
State : VA
Zip : 23704-4106
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 940 THOMAS CIR
Second Line :
City : PORTSMOUTH
State : VA
Zip : 23704-4106
Country : US
Telephone Number : 757-408-6133
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2026
Last Update Date : 03/10/2026

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Directions to “ CHANELL LANEZ PURVIS ” Practice Location

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