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General NPI Number Information
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NPI Number | 1023767720
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Entity Type | Organization
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Legal Business Name | PURPOSE-DRIVEN THERAPEUTIC SERVICES LLC
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Dates
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Enumeration Date | 03/21/2022
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Last Update Date | 03/21/2022
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Provider Practice Location Address
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Address Line | 606 DARLEY RD
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City | CLAYMONT
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State | DE
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Zip | 19703-2211
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Country | US
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Telephone | 302-898-5197
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Fax |
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Provider Business Mailing Address
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Address Line | 2803 PHILADELPHIA PIKE STE B
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City | CLAYMONT
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State | DE
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Zip | 19703-2506
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Country | US
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Telephone | 302-592-0121
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Fax | 302-592-0100
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Authorized Official
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Title or Position | CEO
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Name | MS. SHAYNELLE BORDLEY-BARNES
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Credential | LPC,CADC,CPS,NCC,CCH
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Telephone | 302-592-0121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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