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Organization

PURPOSE DRIVEN INTERVENTION SERVICES

Active
Parent organization
PURPOSE DRIVEN SUPPORT SERVICES
Organization subpart
Yes

Provider details

NPI number
Legal business name
PURPOSE DRIVEN SUPPORT SERVICES
Authorized official
SAMANTHA STUMBO LMFT (OWNER)
(606) 359-0700
Entity
Organization

Contact information

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

Taxonomy

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

Other

Enumeration date
02/03/2025
Last updated
05/05/2025
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