Healthcare Provider Details

I. General information

NPI: 1831695469
Provider Name (Legal Business Name): HOPE CHRISTIAN COUNSELING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2018
Last Update Date: 10/07/2024
Certification Date: 10/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 W SOUTH BOUNDARY ST BLDG 7B
PERRYSBURG OH
43551-5244
US

IV. Provider business mailing address

900 W SOUTH BOUNDARY ST BLDG 7B
PERRYSBURG OH
43551-5244
US

V. Phone/Fax

Practice location:
  • Phone: 419-724-4233
  • Fax: 877-622-7635
Mailing address:
  • Phone: 419-724-4233
  • Fax: 877-622-7635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI-0009614
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License NumberI-0009614
License Number StateOH

VIII. Authorized Official

Name: CINDY J LIVINGSTON
Title or Position: LISW-S
Credential: LISW-S
Phone: 419-724-4233