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General NPI Number Information
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NPI Number | 1235773862
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Entity Type | Individual
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Provider Name | KEVIN ROGER HOPE M.A., ED,S., LMHC
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Gender | Male
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Dates
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Enumeration Date | 11/06/2019
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Last Update Date | 11/04/2023
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Provider Practice Location Address
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Address Line | 1355 US ROUTE 11
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City | KIRKWOOD
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State | NY
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Zip | 13795-1640
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Country | US
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Telephone | 607-222-8032
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1
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City | CONKLIN
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State | NY
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Zip | 13748-0001
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Country | US
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Telephone | 607-235-3101
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Fax | 607-235-3101
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 010018
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License Number State | NY
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