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General NPI Number Information
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NPI Number | 1922553791
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Entity Type | Organization
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Legal Business Name | PURDY INC
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Dates
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Enumeration Date | 08/22/2016
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Last Update Date | 08/22/2016
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Provider Practice Location Address
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Address Line | 902 COMMERCIAL ST
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City | EMPORIA
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State | KS
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Zip | 66801-2917
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Country | US
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Telephone | 620-208-9049
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Fax | 620-208-9049
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Provider Business Mailing Address
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Address Line | 902 COMMERCIAL ST
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City | EMPORIA
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State | KS
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Zip | 66801-2917
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Country | US
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Telephone | 620-208-9049
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Fax | 620-208-9049
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM JOSEPH BERNHARDT-PURDY
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Credential | DSW, LMSW, LPC, LAC
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Telephone | 620-208-9049
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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 | 750
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 4910
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License Number State | KS
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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 | 4910
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License Number State | KS
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