Provider Demographics
NPI:1023640638
Name:PURPOSED BY DESIGN, PLLC
Entity type:Organization
Organization Name:PURPOSED BY DESIGN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DEAHDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAMBERS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:910-975-5127
Mailing Address - Street 1:2910 PAT BOOKER RD TRLR 39
Mailing Address - Street 2:
Mailing Address - City:UNIVERSAL CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78148-2740
Mailing Address - Country:US
Mailing Address - Phone:910-975-5127
Mailing Address - Fax:
Practice Address - Street 1:104 W MAIN ST UNIT B
Practice Address - Street 2:
Practice Address - City:BISCOE
Practice Address - State:NC
Practice Address - Zip Code:27209-9813
Practice Address - Country:US
Practice Address - Phone:910-975-5127
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-11
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)