Basic Information
| Provider Information | |||||||||
| NPI: | 1588949598 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PURSER | ||||||||
| FirstName: | BRENDA | ||||||||
| MiddleName: | B | ||||||||
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| Credential: | CSW,MSSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 501 E BROADWAY STE 290 | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402022040 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5022178221 | ||||||||
| FaxNumber: | 5022175056 | ||||||||
| Practice Location | |||||||||
| Address1: | 215 CENTRAL AVE STE 200 | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402081451 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5028527449 | ||||||||
| FaxNumber: | 5028521423 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/21/2011 | ||||||||
| LastUpdateDate: | 11/02/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 1206 | KY | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.