Healthcare Provider Details

I. General information

NPI: 1841590924
Provider Name (Legal Business Name): HEART OF HOPE COUNSELING AND MEDIATION PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2010
Last Update Date: 11/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 E MAIN ST STE 5
LLANO TX
78643-2000
US

IV. Provider business mailing address

103 E MAIN ST STE 5
LLANO TX
78643-2000
US

V. Phone/Fax

Practice location:
  • Phone: 325-247-4477
  • Fax:
Mailing address:
  • Phone: 830-265-8450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number64330
License Number StateTX

VIII. Authorized Official

Name: MRS. CHRISTI GAIL LUNDBY
Title or Position: OWNER
Credential: LPC
Phone: 325-247-4477