Provider Demographics
| NPI: | 1508640301 |
|---|---|
| Name: | THERAPY WITH PURPOSE, LLC |
| Entity Type: | Organization |
| Organization Name: | THERAPY WITH PURPOSE, LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CEO |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | BRIANNA |
| Authorized Official - Middle Name: | SHACOLE |
| Authorized Official - Last Name: | MARSHALL |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | LCSW, MBA |
| Authorized Official - Phone: | 559-274-3801 |
| Mailing Address - Street 1: | PO BOX 6237 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | GOODYEAR |
| Mailing Address - State: | AZ |
| Mailing Address - Zip Code: | 85338-0621 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 480-404-0844 |
| Mailing Address - Fax: | 480-781-4795 |
| Practice Address - Street 1: | 8607 N 59TH AVE STE C1 |
| Practice Address - Street 2: | |
| Practice Address - City: | GLENDALE |
| Practice Address - State: | AZ |
| Practice Address - Zip Code: | 85302-5435 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 480-404-0844 |
| Practice Address - Fax: | 480-781-4795 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2023-08-22 |
| Last Update Date: | 2023-08-22 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 251S00000X | Agencies | Community/Behavioral Health | ||
| No | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
| No | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Multi-Specialty |
| No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
| No | 106H00000X | Behavioral Health & Social Service Providers | Marriage & Family Therapist | Group - Multi-Specialty | |
| No | 251B00000X | Agencies | Case Management | Group - Multi-Specialty | |
| No | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | ||
| No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | |
| No | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health | |
| No | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health | |
| No | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | |
| No | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder | |
| No | 324500000X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | ||
| No | 3245S0500X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | Substance Abuse Treatment, Children |
