Basic Information
Provider Information | |||||||||
NPI: | 1508062704 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | CONNECTIONS OF HOPE COUNSELING, LLC | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: | CONNECTIONS OF HOPE COUNSELING | ||||||||
OtherOrganizationType: | 3 | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 581 HEBRON RD | ||||||||
Address2: |   | ||||||||
City: | HEATH | ||||||||
State: | OH | ||||||||
PostalCode: | 430561402 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7404050633 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 581 HEBRON RD | ||||||||
Address2: |   | ||||||||
City: | HEATH | ||||||||
State: | OH | ||||||||
PostalCode: | 430561402 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7404050633 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 06/25/2007 | ||||||||
LastUpdateDate: | 07/01/2008 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | RAMSEY | ||||||||
AuthorizedOfficialFirstName: | MILDRED | ||||||||
AuthorizedOfficialMiddleName: | CHRISTINE | ||||||||
AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
AuthorizedOfficialTelephone: | 7404050633 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: | PC | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | C05000131 | OH | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Marriage & Family Therapist |   |
No ID Information.