MEDICARE: THERAPY WITH PURPOSE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	101YA0400X	Addiction (Substance Use Disorder) Counselor
3	101YP2500X	Professional Counselor
4	1041C0700X	Clinical Social Worker
5	106H00000X	Marriage & Family Therapist
6	261Q00000X	Clinic/Center
7	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
8	261QM1300X	Multi-Specialty Clinic/Center
9	261QM0850X	Adult Mental Health Clinic/Center
10	261QM0855X	Adolescent and Children Mental Health Clinic/Center
11	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
12	324500000X	Substance Abuse Rehabilitation Facility
13	3245S0500X	Children's Substance Abuse Rehabilitation Facility
14	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1508640301
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERAPY WITH PURPOSE, LLC

Provider Business Mailing Address
First Line	:	PO BOX 6237
Second Line	:
City	:	GOODYEAR
State	:	AZ
Zip	:	85338-0621
Country	:	US
Telephone Number	:	480-404-0844
Fax Number	:	480-781-4795

Provider Business Practice Location Address
First Line	:	8607 N 59TH AVE STE C1
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85302-5435
Country	:	US
Telephone Number	:	480-404-0844
Fax Number	:	480-781-4795

Authorized Official
Title or Position	:	CEO
Name	:	BRIANNA SHACOLE MARSHALL
Credential	:	LCSW, MBA
Telephone Number	:	559-274-3801

Provider Enumeration Date	:	08/22/2023
Last Update Date	:	08/22/2023

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Directions to “THERAPY WITH PURPOSE, LLC ” Practice Location

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