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NPI Code Detail

MEDICARE: SHIRLEY J PURCELL LCSW

MEDICARE:   SHIRLEY J PURCELL  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker583CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1295958502
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHIRLEY J PURCELL LCSW
Provider Business Mailing Address
First Line : 1650 S TOPAZ WAY
Second Line :
City : MERIDIAN
State : ID
Zip : 83642-4474
Country : US
Telephone Number : 208-605-7070
Fax Number :
Provider Business Practice Location Address
First Line : 3800 AUTOMATION WAY STE 102
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-3451
Country : US
Telephone Number : 970-900-5835
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2007
Last Update Date : 06/10/2024

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Directions to “ SHIRLEY J PURCELL LCSW” Practice Location

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