Healthcare Provider Details

I. General information

NPI: 1649830423
Provider Name (Legal Business Name): HEAL AND HOPE COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2019
Last Update Date: 08/14/2024
Certification Date: 08/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 STUART RD NE STE 101
CLEVELAND TN
37312-5869
US

IV. Provider business mailing address

241 LAKEWOOD CIRCLE DR
DECATUR TN
37322-8243
US

V. Phone/Fax

Practice location:
  • Phone: 423-790-4906
  • Fax: 423-790-7074
Mailing address:
  • Phone: 423-790-4906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN M CONDON
Title or Position: OFFICE MANAGER
Credential:
Phone: 423-790-4906