Healthcare Provider Details

I. General information

NPI: 1164386041
Provider Name (Legal Business Name): KHOURI BARNES PURNELL PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KHOURI BARNES

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3105 CLAIRMONT RD NE
BROOKHAVEN GA
30329-1015
US

IV. Provider business mailing address

3500 DEPAUW BLVD STE 3070
INDIANAPOLIS IN
46268-6135
US

V. Phone/Fax

Practice location:
  • Phone: 470-241-1353
  • Fax: 317-520-8200
Mailing address:
  • Phone: 855-324-0885
  • Fax: 317-520-8200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY004343
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: