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General NPI Number Information
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NPI Number | 1366998767
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Entity Type | Individual
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Provider Name | LASSANDRA PURNELL LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/26/2016
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Last Update Date | 03/09/2023
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Provider Practice Location Address
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Address Line | 1 GLENWOOD AVE
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City | RALEIGH
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State | NC
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Zip | 27603-2578
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Country | US
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Telephone | 919-348-2473
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 356
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City | NEW HILL
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State | NC
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Zip | 27562-0356
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Country | US
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Telephone | 202-286-3616
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | ASW88427
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C015672
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License Number State | NC
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Taxonomy #6
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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