Provider Demographics
NPI:1225381601
Name:PURCHASE AREA SUPPORT SERVICES LLC
Entity Type:Organization
Organization Name:PURCHASE AREA SUPPORT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:270-205-0141
Mailing Address - Street 1:5824 OAK LEVEL RD
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:KY
Mailing Address - Zip Code:42025-5269
Mailing Address - Country:US
Mailing Address - Phone:270-205-0141
Mailing Address - Fax:270-527-1671
Practice Address - Street 1:5824 OAK LEVEL RD
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:KY
Practice Address - Zip Code:42025-5269
Practice Address - Country:US
Practice Address - Phone:270-205-0141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-22
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0522101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty