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General NPI Number Information
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NPI Number | 1063838696
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Entity Type | Organization
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Legal Business Name | HAVEN OF HOPE COUNSELING ASSOCIATES, LLC
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Dates
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Enumeration Date | 03/06/2014
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Last Update Date | 03/06/2014
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Provider Practice Location Address
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Address Line | 1471 ROUTE 9 SUITE 201
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City | CLIFTON PARK
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State | NY
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Zip | 12065-6500
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Country | US
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Telephone | 518-982-5376
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Fax |
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Provider Business Mailing Address
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Address Line | 1471 ROUTE 9 SUITE 201
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City | CLIFTON PARK
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State | NY
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Zip | 12065-6500
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Country | US
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Telephone | 518-982-5376
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | MRS. ANN SIMPSON-MCDOWELL
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Credential | MA, LCAT
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Telephone | 518-982-5376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 001903-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 000806-1
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License Number State | NY
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