MEDICARE: MRS. ROSLYN KATE PURSLEY LPCC

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
1	101YP2500X	Professional Counselor	PRC20001763	DC
2	101YP2500X	Professional Counselor	37PC00830400	NJ
3	101YP2500X	Professional Counselor	LPC21813	AZ
4	101YM0800X	Mental Health Counselor	0139431	NM
5	101YP2500X	Professional Counselor	180015607	IL
6	101YP2500X	Professional Counselor	CP3021-R	NV
7	101YM0800X	Mental Health Counselor	0159951	NM

Other Identifiers

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

General Provider Information

NPI Number	:	1811289499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ROSLYN KATE PURSLEY LPCC

Provider Business Mailing Address
First Line	:	3020 N RICHARDSON AVE
Second Line	:
City	:	ROSWELL
State	:	NM
Zip	:	88201-5875
Country	:	US
Telephone Number	:	575-396-6611
Fax Number	:	575-616-7012

Provider Business Practice Location Address
First Line	:	3020 N RICHARDSON AVE
Second Line	:
City	:	ROSWELL
State	:	NM
Zip	:	88201-5875
Country	:	US
Telephone Number	:	575-363-8814
Fax Number	:	575-616-7012

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2011
Last Update Date	:	03/23/2026

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