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General NPI Number Information
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NPI Number | 1083082184
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Entity Type | Organization
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Legal Business Name | PURNELL COUNSELING INC.
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Dates
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Enumeration Date | 09/04/2015
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Last Update Date | 11/14/2015
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Provider Practice Location Address
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Address Line | 1531 S GROVE AVE SUITE 204
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City | BARRINGTON
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State | IL
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Zip | 60010
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Country | US
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Telephone | 847-701-4144
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Fax |
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Provider Business Mailing Address
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Address Line | 1531 S GROVE AVE SUITE 204
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City | BARRINGTON
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State | IL
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Zip | 60010
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Country | US
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Telephone | 847-701-4144
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | THOMAS PURNELL
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Credential | M.A.
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Telephone | 847-687-7260
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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 | 180.009088
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License Number State | IL
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