MEDICARE: HOPE-JOY-PEACE COUNSELING SERVICES PLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ACSW 882101394	OTHER		NATIONAL ASSOC OF SOCIAL WORKERS/ACADEMY OF CERTIFIED SOCIAL WORKERS
2	2961	OTHER	OK	LCSW

General Provider Information

NPI Number	:	1063716496
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOPE-JOY-PEACE COUNSELING SERVICES PLC

Provider Business Mailing Address
First Line	:	201 N BROADWAY ST
Second Line	:	SUITE 109
City	:	MOORE
State	:	OK
Zip	:	73160-5135
Country	:	US
Telephone Number	:	405-831-7791
Fax Number	:	405-759-2944

Provider Business Practice Location Address
First Line	:	201 N BROADWAY ST
Second Line	:	SUITE 109
City	:	MOORE
State	:	OK
Zip	:	73160-5135
Country	:	US
Telephone Number	:	405-831-7791
Fax Number	:	405-759-2944

Authorized Official
Title or Position	:	SOLE OWNER
Name	:	EVELYN L SEATON
Credential	:	LCSW
Telephone Number	:	405-831-7791

Provider Enumeration Date	:	12/28/2010
Last Update Date	:	12/28/2010

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