Provider Demographics
NPI:1780335364
Name:PURPOSE DRIVEN PASSION COACHING & CONSULTING AGENCY
Entity type:Organization
Organization Name:PURPOSE DRIVEN PASSION COACHING & CONSULTING AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, PRACTIONER,
Authorized Official - Prefix:
Authorized Official - First Name:SYDNYE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:LCAS-A, LCMHC-A
Authorized Official - Phone:336-880-1864
Mailing Address - Street 1:1018 N CALDWELL ST APT 402
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28206-3676
Mailing Address - Country:US
Mailing Address - Phone:336-880-1864
Mailing Address - Fax:
Practice Address - Street 1:1018 N CALDWELL ST APT 402
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28206-3676
Practice Address - Country:US
Practice Address - Phone:336-880-1864
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty