Provider Demographics
NPI:1750252151
Name:PUSH4PURPOSE
Entity type:Organization
Organization Name:PUSH4PURPOSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:DUQUINHA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LMHC
Authorized Official - Phone:617-990-7422
Mailing Address - Street 1:1308 CUMBERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-3417
Mailing Address - Country:US
Mailing Address - Phone:617-990-7422
Mailing Address - Fax:
Practice Address - Street 1:1308 CUMBERLAND AVE
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-3417
Practice Address - Country:US
Practice Address - Phone:617-990-7422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty