Basic Information
| Provider Information | |||||||||
| NPI: | 1518133529 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | H.O.P.E. COUNSELING SERVICES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2820 W CHARLESTON BLVD | ||||||||
| Address2: | SUITE C23 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891021942 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7028093507 | ||||||||
| FaxNumber: | 7024384673 | ||||||||
| Practice Location | |||||||||
| Address1: | 2820 W CHARLESTON BLVD | ||||||||
| Address2: | SUITE C23 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891021942 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7028093507 | ||||||||
| FaxNumber: | 7024384673 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/30/2008 | ||||||||
| LastUpdateDate: | 01/19/2013 | ||||||||
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| AuthorizedOfficialLastName: | MOLDOVAN | ||||||||
| AuthorizedOfficialFirstName: | KATHERINE | ||||||||
| AuthorizedOfficialMiddleName: | A. | ||||||||
| AuthorizedOfficialTitleorPosition: | MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 7028093507 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | L.C.S.W. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 1578634192 | 01 | NV | NPI INDIVIDUAL | OTHER | 1578634192 | 05 | NV | MEDICAID |