Provider Demographics
NPI:1629874193
Name:PURPOSEFUL SPIRIT THERAPY LLC
Entity type:Organization
Organization Name:PURPOSEFUL SPIRIT THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AHMAL
Authorized Official - Middle Name:H
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:702-628-6727
Mailing Address - Street 1:1247 ALA KAPUNA ST APT 101
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-4642
Mailing Address - Country:US
Mailing Address - Phone:702-628-6727
Mailing Address - Fax:
Practice Address - Street 1:1247 ALA KAPUNA ST APT 101
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-4642
Practice Address - Country:US
Practice Address - Phone:702-628-6727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health