Healthcare Provider Details

I. General information

NPI: 1912316399
Provider Name (Legal Business Name): AKWETE PURIFOY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2014
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12624 BUCK RUN DR
NOBLESVILLE IN
46060-4626
US

IV. Provider business mailing address

12624 BUCK RUN DR
NOBLESVILLE IN
46060-4626
US

V. Phone/Fax

Practice location:
  • Phone: 260-348-5766
  • Fax:
Mailing address:
  • Phone: 260-348-5766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34008335A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: