=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568991164
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COUNSELING FOR HOPE AND HEALING, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/07/2017
-----------------------------------------------------
Last Update Date | 07/21/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4937 W BROAD ST
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43228-1646
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-581-3015
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 755 MILITARY DR
-----------------------------------------------------
City | GALLOWAY
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43119-8132
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-581-3015
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MAUREEN SCELZA
-----------------------------------------------------
Credential | LMFT
-----------------------------------------------------
Telephone | 203-581-3015
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------