Healthcare Provider Details

I. General information

NPI: 1922612571
Provider Name (Legal Business Name): HOPE AND HARMONY WELLNESS GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2020
Last Update Date: 03/03/2021
Certification Date: 12/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 N WALL ST
CARBONDALE IL
62901-1735
US

IV. Provider business mailing address

232 TIMBER TRL
CARTERVILLE IL
62918-2384
US

V. Phone/Fax

Practice location:
  • Phone: 310-270-5878
  • Fax:
Mailing address:
  • Phone: 310-270-5878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number
License Number State
# 8
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number
License Number State
# 9
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTIAN HOPE GILLESPIE
Title or Position: FOUNDER/CEO
Credential: PHD
Phone: 310-270-5878