Healthcare Provider Details

I. General information

NPI: 1164006474
Provider Name (Legal Business Name): MYUNG JIN KARA PURVES IMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2021
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4831 DARROW RD STE 106
STOW OH
44224-1409
US

IV. Provider business mailing address

4831 DARROW RD STE 106
STOW OH
44224-1409
US

V. Phone/Fax

Practice location:
  • Phone: 330-576-5259
  • Fax:
Mailing address:
  • Phone: 330-576-5259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: