=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568015048
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ANCHORS OF HOPE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/23/2019
-----------------------------------------------------
Last Update Date | 02/03/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9252 S. SCHOONER CREEK RD
-----------------------------------------------------
City | OTIS
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97368
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-921-1504
-----------------------------------------------------
Fax | 620-682-9840
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4994 N HIGHWAY 101 UNIT 821
-----------------------------------------------------
City | NEOTSU
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97364-0830
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-921-1504
-----------------------------------------------------
Fax | 620-682-9840
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGING MEMBER
-----------------------------------------------------
Name | LAURIE J DOEHASS-IMEL
-----------------------------------------------------
Credential | LCSW, LSCSW
-----------------------------------------------------
Telephone | 541-921-1504
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------