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General NPI Number Information
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NPI Number | 1265120182
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Entity Type | Organization
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Legal Business Name | SHANELLE PURDY LMHC, LLC
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Dates
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Enumeration Date | 04/27/2023
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Last Update Date | 11/15/2024
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Provider Practice Location Address
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Address Line | 87-1510 KUAHA ST
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City | WAIANAE
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State | HI
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Zip | 96792-5414
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Country | US
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Telephone | 808-429-9766
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Fax |
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Provider Business Mailing Address
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Address Line | 87-1510 KUAHA ST
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City | WAIANAE
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State | HI
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Zip | 96792-5414
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Country | US
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Telephone | 808-864-6863
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | SHANELLE PURDY
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Credential | LMHC
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Telephone | 808-864-6863
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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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 | 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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