Provider Demographics
NPI:1346992039
Name:PURGOLD, DENISE MICHELE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:MICHELE
Last Name:PURGOLD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6216 CLUB RD
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23228-5202
Mailing Address - Country:US
Mailing Address - Phone:804-337-2838
Mailing Address - Fax:
Practice Address - Street 1:8100 THREE CHOPT RD
Practice Address - Street 2:SUITE 101
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23229-4833
Practice Address - Country:US
Practice Address - Phone:804-354-1881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-24
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904005539101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health