Healthcare Provider Details

I. General information

NPI: 1205685112
Provider Name (Legal Business Name): HOPE HEART MOMENTUM COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2024
Last Update Date: 06/30/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 SKIPPACK PIKE SUITE B4
SKIPPACK PA
19468-1790
US

IV. Provider business mailing address

PO BOX 26510
COLLEGEVILLE PA
19426-0510
US

V. Phone/Fax

Practice location:
  • Phone: 484-501-4836
  • Fax:
Mailing address:
  • Phone: 484-501-4836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MS. SANDRA L PUCKETT
Title or Position: OWNER
Credential: LPC, LBS
Phone: 484-501-4836