Provider Demographics
NPI:1831813096
Name:PIEDMONT THERAPEUTIC SERVICES,LLC
Entity type:Organization
Organization Name:PIEDMONT THERAPEUTIC SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYD
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:T
Authorized Official - Last Name:PURCELL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:804-314-9462
Mailing Address - Street 1:3215 ROCK CREEK VILLA DR
Mailing Address - Street 2:
Mailing Address - City:QUINTON
Mailing Address - State:VA
Mailing Address - Zip Code:23141-1656
Mailing Address - Country:US
Mailing Address - Phone:804-314-9462
Mailing Address - Fax:
Practice Address - Street 1:3215 ROCK CREEK VILLA DR
Practice Address - Street 2:
Practice Address - City:QUINTON
Practice Address - State:VA
Practice Address - Zip Code:23141-1656
Practice Address - Country:US
Practice Address - Phone:804-314-9462
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-30
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty