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General NPI Number Information
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NPI Number | 1740428275
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Entity Type | Individual
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Provider Name | BRYAN PURCELL LPCC
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Gender | Male
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Dates
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Enumeration Date | 01/21/2009
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Last Update Date | 09/16/2024
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Provider Practice Location Address
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Address Line | 4414 OLD LA GRANGE RD
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City | BUCKNER
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State | KY
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Zip | 40010-9547
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Country | US
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Telephone | 502-222-2389
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Fax | 502-222-2927
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Provider Business Mailing Address
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Address Line | PO BOX 1484
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City | CRESTWOOD
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State | KY
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Zip | 40014-1484
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Country | US
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Telephone | 502-222-2389
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Fax | 502-222-2927
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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 | 102184
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License Number State | KY
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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 | 102184
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1225
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License Number State | KY
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