Provider Demographics
NPI:1639475825
Name:PURVIS, TESHIA W (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:TESHIA
Middle Name:W
Last Name:PURVIS
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1745 FRANK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28560-9605
Mailing Address - Country:US
Mailing Address - Phone:704-577-0085
Mailing Address - Fax:
Practice Address - Street 1:1745 FRANK AVE
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28560-9605
Practice Address - Country:US
Practice Address - Phone:704-577-0085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-04
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1402106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist