Healthcare Provider Details

I. General information

NPI: 1215707625
Provider Name (Legal Business Name): HOPE AND HEALING COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2024
Last Update Date: 01/05/2024
Certification Date: 01/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3311 N UNIVERSITY AVE STE 200
PROVO UT
84604-7421
US

IV. Provider business mailing address

1072 W 1150 S
SPRINGVILLE UT
84663-6161
US

V. Phone/Fax

Practice location:
  • Phone: 801-310-4188
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: RACHEL COOPER
Title or Position: MEMBER
Credential: LCSW
Phone: 801-310-4188