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General NPI Number Information
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NPI Number | 1720874621
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Entity Type | Individual
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Provider Name | BENJAMIN P PURSLEY
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Gender | Male
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Dates
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Enumeration Date | 04/17/2025
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 401 N WALNUT ST
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City | SPRINGFIELD
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State | IL
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Zip | 62702-5033
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Country | US
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Telephone | 217-545-7815
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Fax |
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Provider Business Mailing Address
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Address Line | 311 E UNION AVE
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City | LITCHFIELD
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State | IL
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Zip | 62056-1519
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Country | US
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Telephone | 618-960-1383
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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 | 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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