# PURPOSE DRIVEN INTERVENTION SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PURPOSE DRIVEN SUPPORT SERVICES
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1689488421
- **Legal business name:** PURPOSE DRIVEN SUPPORT SERVICES
- **Authorized official:** SAMANTHA STUMBO LMFT (OWNER)
- **Authorized official phone:** (606) 359-0700

## Contact information

- **Practice address:** 9575 KY HWY 122 STE 6, ST 7, EAST MCDOWELL, KY 41647
- **Practice address phone:** (606) 359-0700
- **Mailing address:** 9575 KY HWY 122 STE 6, ST 7, EAST MCDOWELL, KY 41647
- **Mailing address phone:** (606) 359-0700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | — |
| 171M00000X | Case Manager/Care Coordinator | — | — | — |
| 175T00000X | Peer Specialist | — | NULL | — |
| 175T00000X | Peer Specialist | — | — | — |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 02/03/2025
- **Last updated:** 05/05/2025