NPIMap

Organization Active NPI

Purpose Driven Support Services

  • Community/Behavioral Health Agency
  • East MC Dowell, KY
National Provider Identifier
1780209692
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PURPOSE DRIVEN SUPPORT SERVICES
Practice address
9575 Ky Hwy 122
Suite 6
East MC Dowell, KY 41647-4164
Phone
(606) 949-1623
NPI assigned
Jun 16, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Samantha Stumbo, LMFT, TCADCNPI 1609287226
Title
Ed/ Owner
Phone
(606) 359-0700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

9575 Ky Hwy 122
Suite 6
East MC Dowell, KY 41647-4164

Mailing address

PO Box 41
MC Dowell, KY 41647-0041
Phone (063) 590-7006

Other identifiers 1

IdentifierTypeStateIssuer
7100674370MedicaidKY

National Provider Directory

National Provider Directory
Tax ID family
Purpose Driven Support Services4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708041600000",
    "number": "1780209692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41",
            "city": "MC DOWELL",
            "state": "KY",
            "postal_code": "416470041",
            "telephone_number": "063-590-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9575 KY HWY 122",
            "address_2": "SUITE 6",
            "city": "EAST MC DOWELL",
            "state": "KY",
            "postal_code": "416474164",
            "telephone_number": "606-949-1623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURPOSE DRIVEN SUPPORT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-16",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A",
        "authorized_official_last_name": "STUMBO",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "ED/ OWNER",
        "authorized_official_telephone_number": "606-359-0700",
        "authorized_official_credential": "LMFT, TCADC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100674370",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.