Provider Demographics
NPI:1578894531
Name:PURCELL, SANTANA SADE
Entity Type:Individual
Prefix:
First Name:SANTANA
Middle Name:SADE
Last Name:PURCELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 TRIAD CENTER DR
Mailing Address - Street 2:SUITE 350
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27409-9073
Mailing Address - Country:US
Mailing Address - Phone:336-931-1800
Mailing Address - Fax:336-931-1801
Practice Address - Street 1:7900 TRIAD CENTER DR
Practice Address - Street 2:SUITE 350
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27409-9073
Practice Address - Country:US
Practice Address - Phone:336-931-1800
Practice Address - Fax:336-931-1801
Is Sole Proprietor?:No
Enumeration Date:2010-01-14
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health