Healthcare Provider Details

I. General information

NPI: 1285128603
Provider Name (Legal Business Name): ABBEY MARIE HOPE LCP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2018
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2537 EISENHOWER RD
OTTAWA KS
66067-9482
US

IV. Provider business mailing address

PO BOX 677
OTTAWA KS
66067-0677
US

V. Phone/Fax

Practice location:
  • Phone: 785-242-3780
  • Fax: 785-242-6397
Mailing address:
  • Phone: 785-242-3780
  • Fax: 785-242-6397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number00884
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2846
License Number StateKS
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number01511
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: