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General NPI Number Information
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NPI Number | 1255043410
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Entity Type | Organization
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Legal Business Name | HOPE AND HEALING BEHAVIORAL HEALTH PLLC
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Dates
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Enumeration Date | 12/20/2022
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Last Update Date | 12/20/2022
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Provider Practice Location Address
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Address Line | 5130 HICKORY POINT FRONTAGE RD STE 230
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City | DECATUR
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State | IL
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Zip | 62526-9773
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Country | US
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Telephone | 217-207-0041
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Fax | 217-207-0042
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Provider Business Mailing Address
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Address Line | 1135 ROSEWOOD DR
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City | MOUNT ZION
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State | IL
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Zip | 62549-1046
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Country | US
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Telephone | 217-207-0041
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Fax | 217-207-0042
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | JENNIFER ZERFOWSKI
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Credential | LCSW
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Telephone | 217-207-0041
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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