Provider Demographics
NPI:1023644598
Name:PURSELL, MONIKA FAYNE (MA, LCHMHC, LCAS-A)
Entity type:Individual
Prefix:MS
First Name:MONIKA
Middle Name:FAYNE
Last Name:PURSELL
Suffix:
Gender:F
Credentials:MA, LCHMHC, LCAS-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 ALEXANDER DR APT 123
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-3775
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10 ALEXANDER DR APT 123
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-3775
Practice Address - Country:US
Practice Address - Phone:614-940-1535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-17
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0016135101YM0800X
NC16793101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health