Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Corey Isaiah Purnell, CSACSUPERVISEE

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1508615204

Corey Isaiah Purnell, CSACSUPERVISEE is an Addiction (Substance Use Disorder) Counselor in Annandale, Virginia. Practices as a sole proprietor. Licensed in Virginia.

Licensed in
VA
In the registry since
2024

Practice location Address checks out

5105Q Backlick Rd
Annandale, VA 22003-6072
Phone: (571) 517-2430
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 0709025467 (VA)

Record details

NPI number1508615204
Entity typeIndividual (Type 1)
GenderMale
Credentials CSACSUPERVISEE
Sole proprietorYes
NPI enumeratedMay 15, 2024
Last updated in NPPESMay 15, 2024
Certification dateMay 15, 2024

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