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General NPI Number Information
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NPI Number | 1871170449
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Entity Type | Organization
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Legal Business Name | DEFINED WITH PURPOSE INC
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Dates
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Enumeration Date | 03/28/2021
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Last Update Date | 03/28/2021
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Provider Practice Location Address
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Address Line | 337 W PIKE ST
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-4843
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Country | US
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Telephone | 404-707-4434
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Fax |
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Provider Business Mailing Address
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Address Line | 337 W PIKE ST
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-4843
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTION
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Name | KELLY ELIZABETH HUGHES
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Credential | LPC
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Telephone | 770-695-7501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #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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