Provider Demographics
NPI:1235872250
Name:PURPOSEFUL LIVING COUNSELING SERVICE, PLLC
Entity Type:Organization
Organization Name:PURPOSEFUL LIVING COUNSELING SERVICE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN AND OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC, LCAS-A
Authorized Official - Phone:336-848-9622
Mailing Address - Street 1:900 OLD WINSTON RD STE 104
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-9965
Mailing Address - Country:US
Mailing Address - Phone:133-649-3364
Mailing Address - Fax:
Practice Address - Street 1:900 OLD WINSTON RD STE 104
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-9965
Practice Address - Country:US
Practice Address - Phone:336-493-3647
Practice Address - Fax:336-217-8500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-18
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty