Provider Demographics
NPI:1871254953
Name:STURGILL, LOLA DARLENE (MS, QMHP)
Entity Type:Individual
Prefix:
First Name:LOLA
Middle Name:DARLENE
Last Name:STURGILL
Suffix:
Gender:F
Credentials:MS, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1662
Mailing Address - Street 2:
Mailing Address - City:MOUNT CARMEL
Mailing Address - State:TN
Mailing Address - Zip Code:37645-1662
Mailing Address - Country:US
Mailing Address - Phone:423-202-6481
Mailing Address - Fax:
Practice Address - Street 1:119 NICOLE DR
Practice Address - Street 2:
Practice Address - City:MOUNT CARMEL
Practice Address - State:TN
Practice Address - Zip Code:37645-3690
Practice Address - Country:US
Practice Address - Phone:423-202-6481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-31
Last Update Date:2021-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health