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General NPI Number Information
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NPI Number | 1174997589
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Entity Type | Organization
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Legal Business Name | HOPE LIGHT COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 11/23/2015
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Last Update Date | 11/23/2015
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Provider Practice Location Address
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Address Line | 9 W 5TH AVE
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City | EMPORIA
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State | KS
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Zip | 66801-4035
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Country | US
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Telephone | 620-481-6036
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Fax | 620-208-6145
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Provider Business Mailing Address
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Address Line | 9 W 5TH AVE
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City | EMPORIA
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State | KS
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Zip | 66801-4035
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Country | US
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Telephone | 620-481-6036
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Fax | 620-208-6145
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Authorized Official
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Title or Position | OWNER
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Name | CYNTHIA KAYE MAXWELL
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Credential | LSCSW
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Telephone | 620-481-6036
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 3975
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License Number State | KS
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