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General NPI Number Information
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NPI Number | 1255922993
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Entity Type | Organization
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Legal Business Name | PURPOSE DRIVEN COUNSELING, LLC
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Dates
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Enumeration Date | 01/26/2021
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Last Update Date | 01/26/2021
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Provider Practice Location Address
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Address Line | 737 DUNN RD
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City | HAZELWOOD
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State | MO
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Zip | 63042-1740
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Country | US
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Telephone | 314-322-3456
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Fax |
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Provider Business Mailing Address
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Address Line | 507 SARATOGA LN
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City | HAZELWOOD
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State | MO
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Zip | 63042-1824
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Country | US
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Telephone | 314-322-3456
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHALA TAYLOR
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Credential | LPC
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Telephone | 314-322-3456
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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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