Healthcare Provider Details

I. General information

NPI: 1952117798
Provider Name (Legal Business Name): RESTORING HOPE COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2024
Last Update Date: 12/06/2024
Certification Date: 12/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1435 MARKET AVE N
CANTON OH
44714-2609
US

IV. Provider business mailing address

1019 10TH ST NW
CANTON OH
44703-3380
US

V. Phone/Fax

Practice location:
  • Phone: 330-861-2444
  • Fax:
Mailing address:
  • Phone: 330-861-2444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: TONYA WATTS
Title or Position: OWNER
Credential: LPCC-S
Phone: 330-861-2444