Healthcare Provider Details

I. General information

NPI: 1144960113
Provider Name (Legal Business Name): HOPE & HEALING THERAPY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2022
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 W CENTRE AVE STE 211
PORTAGE MI
49024-5344
US

IV. Provider business mailing address

1611 W CENTRE AVE STE 211
PORTAGE MI
49024-5344
US

V. Phone/Fax

Practice location:
  • Phone: 269-203-5933
  • Fax:
Mailing address:
  • Phone: 269-203-5933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: JULIE MCKINSTRY WALDRON
Title or Position: THERAPIST/OWNER
Credential: MA, LLP, LPC
Phone: 269-203-5933