KHOURI DANIELLE BARNES PURNELL, Psy.D. — NPI 1164386041 (Licensed & Credentialed Behavioral Health & Social Service Providers

CMS-1500 Box 24J / 33a • NPI

1164386041

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

103T00000X (CMS 62)

Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist

Box 32 Service Location & ZIP+4

3105 CLAIRMONT RD NE, BROOKHAVEN, GA, 30329-1015

✓ 9-Digit EDI 837 ZIP+4 (30329-1015)

Practice Phone & Referral Fax

(470) 241-1353

Fax: (317) 520-8200

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1164386041 (KHOURI DANIELLE BARNES PURNELL, Psy.D.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1164386041` (NPI-1 Individual Practitioner)
Provider / Legal Name	KHOURI DANIELLE BARNES PURNELL, Psy.D.
Plain-English Specialty	Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist NUCC Code: `103T00000X` (Psychologist)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	3105 CLAIRMONT RD NE, BROOKHAVEN, GA, 30329-1015
Practice Telephone / Fax	Tel: (470) 241-1353 \| Fax: (317) 520-8200
Administrative Mailing Address	3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN, 46268-6135
Enumeration & Last Sync	Enumerated: 2025-12-15 \| CMS Record Updated: 2026-07-13

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

3105 CLAIRMONT RD NE, BROOKHAVEN, GA, 30329-1015

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Plain-English Taxonomy & CMS Crosswalk (103T00000X)

What Does Taxonomy Code 103T00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 103T00000X translates to:
"Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 62 (Psychologist, Clinical)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Psychologist for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (KHOURI DANIELLE BARNES PURNELL, Psy.D.)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`103T00000X` — Psychologist Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist	State: GA \| License: `PSY004343` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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KHOURI DANIELLE BARNES PURNELL, Psy.D. (NPI #1164386041)