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General NPI Number Information
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NPI Number | 1255871026
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Entity Type | Organization
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Legal Business Name | HOPE JESC INC
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Dates
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Enumeration Date | 02/27/2017
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Last Update Date | 03/17/2017
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Provider Practice Location Address
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Address Line | 1583 ALBANY AVE
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City | BROOKLYN
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State | NY
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Zip | 11210-3520
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Country | US
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Telephone | 516-784-8744
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Fax |
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Provider Business Mailing Address
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Address Line | 1583 ALBANY AVE
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City | BROOKLYN
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State | NY
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Zip | 11210-3520
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | RYAN J DOUPE
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Credential | LMHC
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Telephone | 516-784-8744
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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 | 007404-1
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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 | 005125-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 100120
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 007719
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License Number State | NY
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