Provider Demographics
NPI:1316654924
Name:PURPOSE,PLLC
Entity type:Organization
Organization Name:PURPOSE,PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADOLESCENT THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KEDISHA
Authorized Official - Middle Name:A
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:719-749-1143
Mailing Address - Street 1:PO BOX 25205
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80936-5205
Mailing Address - Country:US
Mailing Address - Phone:719-749-1143
Mailing Address - Fax:
Practice Address - Street 1:919 N WEBER ST FL 2
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-2976
Practice Address - Country:US
Practice Address - Phone:719-749-1143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-02
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty