PURE SUPPORT LLC NPI 1578271151

NPI Information

  • NPI: 1578271151
  • Provider Name: PURE SUPPORT LLC
  • Classification: Peer Specialist - 175T00000X
  • Entity Type: Organization
  • Other Name: PURE SUPPORT
  • Address: 3770 COUNTY ROAD F N
    DELAVAN, WI
    ZIP 53115
  • Phone: (262) 203-0247

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NPI Details

PURE SUPPORT LLC is a peer specialist in Delavan, WI. The provider is individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. PURE SUPPORT LLC NPI is 1578271151. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Pure Support.

The provider's business location address is:

3770 COUNTY ROAD F N
DELAVAN, WI
ZIP 53115-963
Phone: (262) 203-0247

The provider's authorized official is Mitchell Sherman .
The authorized official title is Member, Manager, Founder and has the following contact phone number (262) 203-0247.

The enumeration date for this NPI number is 11/11/2022 and was last updated on 12/16/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1171400000XHealth and Wellness CoachNo
2172V00000XCommunity Health WorkerNo
3174400000XSpecialistNo
4225400000XRehabilitation PractitionerNo
5225800000XRecreation TherapistNo
6372600000XAdult CompanionNo
7373H00000XDay Training/Habilitation SpecialistNo
8374J00000XDoulaNo
9374K00000XReligious Nonmedical PractitionerNo
10390200000XStudent in an Organized Health Care Education/Training ProgramNo
11405300000XPrevention ProfessionalNo
12175T00000XPeer SpecialistYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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