Provider Demographics
NPI:1023431277
Name:PURVIS, TINGER (LPC)
Entity type:Individual
Prefix:
First Name:TINGER
Middle Name:
Last Name:PURVIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5335 ANTIOCH CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLESEX
Mailing Address - State:NC
Mailing Address - Zip Code:27557-9044
Mailing Address - Country:US
Mailing Address - Phone:919-810-3846
Mailing Address - Fax:919-404-3651
Practice Address - Street 1:5335 ANTIOCH CHURCH RD
Practice Address - Street 2:
Practice Address - City:MIDDLESEX
Practice Address - State:NC
Practice Address - Zip Code:27557-9044
Practice Address - Country:US
Practice Address - Phone:919-810-3846
Practice Address - Fax:919-404-3651
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-23
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9377101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional