Individual
MRS. LISA RENEE PURYEAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2212 DEVINE ST, COLUMBIA, SC 29205-2402
(803) 573-4463
Mailing address
2417 CRAIG RD, COLUMBIA, SC 29204-2632
(803) 403-7891
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
209
SC
101YM0800X
Mental Health Counselor
Primary
6824
SC
Other
Enumeration date
05/18/2016
Last updated
02/18/2025
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