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NPI Code Detail

MEDICARE: IGNITING HOPE THROUGH HEALING LLC

MEDICARE: IGNITING HOPE THROUGH HEALING LLC
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1417753021
Entity Type Code : Organization
Provider Name (Legal Business Name) : IGNITING HOPE THROUGH HEALING LLC
Provider Business Mailing Address
First Line : 1727 KELLER PKWY
Second Line :
City : KELLER
State : TX
Zip : 76248-3705
Country : US
Telephone Number : 682-593-5395
Fax Number :
Provider Business Practice Location Address
First Line : 1727 KELLER PKWY
Second Line :
City : KELLER
State : TX
Zip : 76248-3705
Country : US
Telephone Number : 682-593-5395
Fax Number :
Authorized Official
Title or Position : OWNER/COUNSELOR
Name : JAMIEL LOTZ
Credential :
Telephone Number : 661-202-9530
Provider Enumeration Date : 02/24/2025
Last Update Date : 02/24/2025

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Directions to “IGNITING HOPE THROUGH HEALING LLC ” Practice Location

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