Provider Demographics
NPI:1538108030
Name:BARRETT, LAURA PURVIS (MA, LPC)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:PURVIS
Last Name:BARRETT
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 SARDIS RD N
Mailing Address - Street 2:SUITE 207
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28270-1426
Mailing Address - Country:US
Mailing Address - Phone:704-708-6538
Mailing Address - Fax:704-573-4560
Practice Address - Street 1:1811 SARDIS RD N
Practice Address - Street 2:SUITE 207
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28270-1426
Practice Address - Country:US
Practice Address - Phone:704-708-6538
Practice Address - Fax:704-573-4560
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3265101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional