Healthcare Provider Details

I. General information

NPI: 1154247666
Provider Name (Legal Business Name): ANCHORED HOPE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1865 LIME ST STE 103
FERNANDINA BEACH FL
32034-4779
US

IV. Provider business mailing address

1865 LIME ST STE 103
FERNANDINA BEACH FL
32034-4779
US

V. Phone/Fax

Practice location:
  • Phone: 973-997-9713
  • Fax:
Mailing address:
  • Phone: 973-997-9713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: PATRICK JAMES HANSON
Title or Position: CO OWNER
Credential: DSW
Phone: 973-274-4557