Healthcare Provider Details

I. General information

NPI: 1538513205
Provider Name (Legal Business Name): HOPE COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2016
Last Update Date: 04/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 CAMINO DE LOS MARQUEZ
SANTA FE NM
87505-1837
US

IV. Provider business mailing address

505 CAMINO DE LOS MARQUEZ
SANTA FE NM
87505-1837
US

V. Phone/Fax

Practice location:
  • Phone: 505-490-1801
  • Fax: 505-455-8876
Mailing address:
  • Phone: 505-490-1801
  • Fax: 505-455-8876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0120871
License Number StateNM

VIII. Authorized Official

Name: MARY T RODRIGUES
Title or Position: OWNER
Credential: MS, LPCC
Phone: 505-862-1418