MEDICARE: HOPE COUNSELING CENTER, INC.

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	101YM0800X	Mental Health Counselor	MH3325	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1427247683	OTHER	FL	INDIVIDUAL NPI NUMBER

General Provider Information

NPI Number	:	1740696590
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOPE COUNSELING CENTER, INC.

Provider Business Mailing Address
First Line	:	PO BOX 720306
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32872-0306
Country	:	US
Telephone Number	:	407-697-6607
Fax Number	:	877-205-6060

Provider Business Practice Location Address
First Line	:	7212 CURRY FORD RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32822-5806
Country	:	US
Telephone Number	:	407-697-6607
Fax Number	:	877-205-6060

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ELTON HUME
Credential	:	LMHC
Telephone Number	:	407-697-6607

Provider Enumeration Date	:	07/01/2014
Last Update Date	:	07/01/2014

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