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General NPI Number Information
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NPI Number | 1174721021
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Entity Type | Individual
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Provider Name | VICKIE ELDRIDGE PURDY LPC
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Gender | Female
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Dates
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Enumeration Date | 07/03/2007
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Last Update Date | 02/14/2024
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Provider Practice Location Address
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Address Line | 1629 HIGHWAY 17
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City | LITTLE RIVER
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State | SC
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Zip | 29566-9229
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Country | US
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Telephone | 361-494-4171
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Fax |
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Provider Business Mailing Address
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Address Line | 523 QUAIL CT
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City | LONGS
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State | SC
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Zip | 29568-8637
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Country | US
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Telephone | 210-883-5335
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Fax |
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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 | 18352
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 9468
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License Number State | SC
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