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General NPI Number Information
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NPI Number | 1245998012
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Entity Type | Organization
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Legal Business Name | FOUNTAIN OF HOPE COUNSELING INC
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Dates
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Enumeration Date | 11/29/2021
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 2151 S HIGHWAY 92 STE 104
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City | SIERRA VISTA
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State | AZ
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Zip | 85635-5283
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Country | US
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Telephone | 520-266-1819
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Fax |
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Provider Business Mailing Address
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Address Line | 2151 S HIGHWAY 92 STE 104
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City | SIERRA VISTA
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State | AZ
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Zip | 85635-5283
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Country | US
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Telephone | 520-266-1819
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR/COUNSELOR
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Name | BRENDA R PARKER
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Credential |
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Telephone | 520-266-1819
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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 |
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License Number State |
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