MEDICARE: FAITH AND HOPE COUNSELING SERVICES, 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
1	1041C0700X	Clinical Social Worker	SW004640	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A904492	OTHER	MO	VALUE OPTIONS
2	0007582461	OTHER	MO	AETNA
3	A904492	OTHER	MO	REGENCE BLUE SHIELD

General Provider Information

NPI Number	:	1821153438
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAITH AND HOPE COUNSELING SERVICES, LLC

Provider Business Mailing Address
First Line	:	FAITH AND HOPE COUNSELING SERVICES, LLC
Second Line	:	1000 LK. ST. LOUIS BLVD. STE 204
City	:	LAKE ST. LOUIS
State	:	MO
Zip	:	63367-2921
Country	:	US
Telephone Number	:	636-332-4487
Fax Number	:	636-639-6755

Provider Business Practice Location Address
First Line	:	FAITH AND HOPE COUNSELING SERVICES, LLC
Second Line	:	1000 LK. ST. LOUIS BLVD. STE 204
City	:	LAKE ST. LOUIS
State	:	MO
Zip	:	63367-2921
Country	:	US
Telephone Number	:	636-332-4487
Fax Number	:	636-639-6755

Authorized Official
Title or Position	:	OWNER
Name	:	REBECCA CORINNE TURAY
Credential	:	MSW, LCSW
Telephone Number	:	636-561-5673

Provider Enumeration Date	:	12/26/2006
Last Update Date	:	08/22/2020

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Directions to “FAITH AND HOPE COUNSELING SERVICES, LLC ” Practice Location

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