Provider Demographics
NPI:1023767720
Name:PURPOSE-DRIVEN THERAPEUTIC SERVICES LLC
Entity type:Organization
Organization Name:PURPOSE-DRIVEN THERAPEUTIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAYNELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BORDLEY-BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:LPC,CADC,CPS,NCC,CCH
Authorized Official - Phone:302-592-0121
Mailing Address - Street 1:2803 PHILADELPHIA PIKE STE B
Mailing Address - Street 2:
Mailing Address - City:CLAYMONT
Mailing Address - State:DE
Mailing Address - Zip Code:19703-2506
Mailing Address - Country:US
Mailing Address - Phone:302-592-0121
Mailing Address - Fax:302-592-0100
Practice Address - Street 1:606 DARLEY RD
Practice Address - Street 2:
Practice Address - City:CLAYMONT
Practice Address - State:DE
Practice Address - Zip Code:19703-2211
Practice Address - Country:US
Practice Address - Phone:302-898-5197
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty