Provider Demographics
NPI:1225187651
Name:PURCELL, JULIE F (LCSW THM)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:F
Last Name:PURCELL
Suffix:
Gender:F
Credentials:LCSW THM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 PRICE ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-1431
Mailing Address - Country:US
Mailing Address - Phone:919-493-9109
Mailing Address - Fax:
Practice Address - Street 1:2310 PRICE ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-1431
Practice Address - Country:US
Practice Address - Phone:919-493-9109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0012591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC60312OtherNC STATE HEALTH PLAN
NC60312OtherBCBS
NC60312OtherBCBS