Healthcare Provider Details

I. General information

NPI: 1689263857
Provider Name (Legal Business Name): CENTER FOR HOPE AND RENEWAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2021
Last Update Date: 01/13/2021
Certification Date: 01/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 MONTGOMERY ST STE 2
JERSEY CITY NJ
07302-5052
US

IV. Provider business mailing address

201 MONTGOMERY ST STE 2
JERSEY CITY NJ
07302-5052
US

V. Phone/Fax

Practice location:
  • Phone: 201-687-9365
  • Fax:
Mailing address:
  • Phone: 201-687-9365
  • 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 Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CATHY S. HONG
Title or Position: EXECUTIVE DIRECTOR
Credential: LPC
Phone: 201-446-9206