Healthcare Provider Details

I. General information

NPI: 1477457083
Provider Name (Legal Business Name): HOPE RENEWED COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 CAMP ST STE B
LOGANVILLE GA
30052-3284
US

IV. Provider business mailing address

PO BOX 2404
LOGANVILLE GA
30052-0056
US

V. Phone/Fax

Practice location:
  • Phone: 678-539-8761
  • Fax:
Mailing address:
  • Phone: 678-539-8761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: YERINA KNOBLOCK
Title or Position: OWNER
Credential: LMFT
Phone: 949-289-1000