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General NPI Number Information
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NPI Number | 1134831894
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Entity Type | Organization
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Legal Business Name | JENNIFER PURSWELL LPC, LLC
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Dates
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Enumeration Date | 12/14/2022
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Last Update Date | 12/14/2022
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Provider Practice Location Address
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Address Line | 7025 NW LONE PINE LN
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City | TERREBONNE
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State | OR
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Zip | 97760
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Country | US
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Telephone | 541-420-7317
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Fax | 458-292-1525
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Provider Business Mailing Address
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Address Line | P.O. BOX 525
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City | REDMOND
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State | OR
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Zip | 97756
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Country | US
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Telephone | 541-420-7317
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Fax | 458-292-1525
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MRS. JENNIFER PURSWELL
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Credential | LPC
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Telephone | 541-420-7317
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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