Healthcare Provider Details
I. General information
NPI: 1811289499
Provider Name (Legal Business Name): ROSLYN KATE PURSLEY LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/13/2011
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1600 NORTH MAIN
LOVINGTON NM
88260-2830
US
IV. Provider business mailing address
1600 NORTH MAIN
LOVINGTON NM
88260-2830
US
V. Phone/Fax
- Phone: 575-396-6611
- Fax: 575-396-1454
- Phone: 575-396-6611
- Fax: 575-396-1454
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 0139431 |
| License Number State | NM |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | CP3021-R |
| License Number State | NV |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 0159951 |
| License Number State | NM |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: