Healthcare Provider Details

I. General information

NPI: 1710557681
Provider Name (Legal Business Name): HOPE THROUGH HEALING THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2021
Last Update Date: 02/04/2022
Certification Date: 02/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2207 DELANEY DR
BURLINGTON NC
27215-5263
US

IV. Provider business mailing address

105 S WILLIAMSON AVE # 173
ELON NC
27244-9204
US

V. Phone/Fax

Practice location:
  • Phone: 919-590-3586
  • Fax: 336-586-5544
Mailing address:
  • Phone: 919-590-3586
  • Fax: 336-586-5544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: CASSANDRA OTERO
Title or Position: LCMHCA
Credential: LCMHCA, NCC, MA
Phone: 919-590-3586