Provider Demographics
NPI:1578266813
Name:PURPOSE WELLNESS CENTER PLLC
Entity Type:Organization
Organization Name:PURPOSE WELLNESS CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAUNA
Authorized Official - Middle Name:
Authorized Official - Last Name:FAILE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFTA
Authorized Official - Phone:215-771-5259
Mailing Address - Street 1:139 ENGLISH HILLS DR
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28115-5781
Mailing Address - Country:US
Mailing Address - Phone:215-771-5259
Mailing Address - Fax:
Practice Address - Street 1:542 WILLIAMSON RD STE 4
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-9138
Practice Address - Country:US
Practice Address - Phone:215-771-5259
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-24
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Single Specialty