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General NPI Number Information
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NPI Number | 1063576973
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Entity Type | Individual
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Provider Name | BRIAN GREGORY PURNELL M.ED.,LPC,ACS,EAS-C
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Gender | Male
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Dates
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Enumeration Date | 12/22/2006
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Last Update Date | 09/14/2016
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Provider Practice Location Address
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Address Line | 3722 BENSON DR SUITE 101
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City | RALEIGH
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State | NC
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Zip | 27609-7388
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Country | US
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Telephone | 919-454-4039
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Fax | 240-266-0062
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Provider Business Mailing Address
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Address Line | 3722 BENSON DR SUITE 101
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City | RALEIGH
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State | NC
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Zip | 27609-7388
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Country | US
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Telephone | 919-454-4039
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Fax | 240-266-0062
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 5551
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License Number State | NC
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