Healthcare Provider Details

I. General information

NPI: 1336249556
Provider Name (Legal Business Name): TAUNDRA LAFAYE THOMPSON-PURNELL LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3545 LAKE ALFRED RD
WINTER HAVEN FL
33881-1447
US

IV. Provider business mailing address

3545 LAKE ALFRED RD
WINTER HAVEN FL
33881-1447
US

V. Phone/Fax

Practice location:
  • Phone: 863-269-0173
  • Fax: 863-269-0175
Mailing address:
  • Phone: 863-269-0173
  • Fax: 863-269-0175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH9843
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: