Provider Demographics
NPI:1396115754
Name:PURCELL, DEIDRE (MA)
Entity type:Individual
Prefix:
First Name:DEIDRE
Middle Name:
Last Name:PURCELL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 MURRAY HILL RD
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-1011
Mailing Address - Country:US
Mailing Address - Phone:617-953-7278
Mailing Address - Fax:
Practice Address - Street 1:12 MURRAY HILL RD
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02140-1011
Practice Address - Country:US
Practice Address - Phone:617-953-7278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-29
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health