Basic Information
| Provider Information | |||||||||
| NPI: | 1871820019 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOPE COUNSELING SERVICES, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 505 MOUNT VERNON RD | ||||||||
| Address2: | #300 | ||||||||
| City: | NEWARK | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430554682 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7405224673 | ||||||||
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| Practice Location | |||||||||
| Address1: | 505 MOUNT VERNON RD | ||||||||
| Address2: | #300 | ||||||||
| City: | NEWARK | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430554682 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7405224673 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/09/2009 | ||||||||
| LastUpdateDate: | 05/16/2014 | ||||||||
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| AuthorizedOfficialLastName: | COLLEN | ||||||||
| AuthorizedOfficialFirstName: | REBECCA | ||||||||
| AuthorizedOfficialMiddleName: | PACK | ||||||||
| AuthorizedOfficialTitleorPosition: | CLINICAL COUNSELOR-SUPERVISOR | ||||||||
| AuthorizedOfficialTelephone: | 7405224673 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | LPCC-S | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261Q00000X | E0007806 | OH | Y | Ambulatory Health Care Facilities | Clinic/Center |
No ID Information.