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NPI 1457933079

NPI 1457933079 : SCENIC HOPE COUNSELING, LLC : GREEN BAY, WI

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General NPI Number Information
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    NPI Number           |    1457933079
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    Entity Type          |    Organization 
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    Legal Business Name  |    SCENIC HOPE COUNSELING, LLC 
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Dates
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    Enumeration Date     |    04/23/2021
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    Last Update Date     |    08/29/2025
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Provider Practice Location Address
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    Address Line         |    1595 ALLOUEZ AVE STE 3 
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    City                 |    GREEN BAY
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    State                |    WI
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    Zip                  |    54311-6267
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    Country              |    US
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    Telephone            |    920-214-5844
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1595 ALLOUEZ AVE STE 3 
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    City                 |    GREEN BAY
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    State                |    WI
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    Zip                  |    54311-6267
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    Country              |    US
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    Telephone            |    920-214-5844
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    Fax                  |    844-903-4616
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Authorized Official
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    Title or Position    |    LICENSED PROFESSIONAL COUNSELOR
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    Name                 |     EMILY M EBBEN 
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    Credential           |    LPC
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    Telephone            |    920-214-5828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QM0850X
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    Taxonomy Name        |    Adult Mental Health Clinic/Center
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    261QM0855X
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    Taxonomy Name        |    Adolescent and Children Mental Health Clinic/Center
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    261QM0801X
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    Taxonomy Name        |    Mental Health Clinic/Center (Including Community Mental Health Center)
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    License Number       |    
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    License Number State |    
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