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General NPI Number Information
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NPI Number | 1467831594
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC HOPE
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Dates
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Enumeration Date | 05/21/2015
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Last Update Date | 05/21/2015
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Provider Practice Location Address
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Address Line | 3750 OCEANSIDE ST
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City | NORTH PORT
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State | FL
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Zip | 34286-1981
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Country | US
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Telephone | 941-914-5168
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Fax |
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Provider Business Mailing Address
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Address Line | 3750 OCEANSIDE ST
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City | NORTH PORT
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State | FL
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Zip | 34286-1981
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Country | US
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Telephone | 941-914-5168
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Fax |
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Authorized Official
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Title or Position | LMHC
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Name | RACHAEL A TRIPPETT
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Credential | LMHC
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Telephone | 941-914-5168
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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 | MH12907
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License Number State | FL
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