Healthcare Provider Details

I. General information

NPI: 1902383789
Provider Name (Legal Business Name): HER HOPE BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2018
Last Update Date: 08/08/2022
Certification Date: 08/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 DATURA ST STE 1015
WEST PALM BEACH FL
33401-5638
US

IV. Provider business mailing address

3733 UNIVERSITY BLVD W STE 208
JACKSONVILLE FL
32217-2103
US

V. Phone/Fax

Practice location:
  • Phone: 888-984-2523
  • Fax:
Mailing address:
  • Phone: 888-984-2523
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ALEXIE BELLE
Title or Position: CEO
Credential: LMHC
Phone: 888-984-2523