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General NPI Number Information
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NPI Number | 1235063611
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Entity Type | Organization
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Legal Business Name | PURPLE CANOPY LLC
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Dates
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Enumeration Date | 06/10/2026
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Last Update Date | 06/10/2026
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Provider Practice Location Address
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Address Line | 10205 US HIGHWAY 15 501 UNIT 26-270
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City | SOUTHERN PINES
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State | NC
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Zip | 28387-5179
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Country | US
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Telephone | 910-660-1900
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Fax | 855-895-5224
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Provider Business Mailing Address
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Address Line | 10205 US HIGHWAY 15 501 UNIT 26-270
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City | SOUTHERN PINES
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State | NC
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Zip | 28387-5179
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Country | US
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Telephone | 910-660-1900
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Fax | 855-895-5224
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Authorized Official
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Title or Position | DIRECTOR
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Name | DENISE DAUVAL
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Credential |
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Telephone | 978-500-0771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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