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General NPI Number Information
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NPI Number | 1598206856
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Entity Type | Organization
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Legal Business Name | HOPE VIRTUAL COUNSELING & THERAPY LLC
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Dates
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Enumeration Date | 03/20/2017
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 2271 PARK AVE
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City | INDIAN LAKE ESTATES
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State | FL
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Zip | 33855
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Country | US
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Telephone | 478-919-7879
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Fax |
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Provider Business Mailing Address
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Address Line | 815 N HOMESTEAD BLVD STE 228
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City | HOMESTEAD
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State | FL
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Zip | 33030-5024
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Country | US
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Telephone | 478-783-4374
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Fax | 478-783-4374
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Authorized Official
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Title or Position | LPC, LMHC
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Name | ROCHELY TERRON
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Credential |
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Telephone | 478-919-7879
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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 | LPC008877
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License Number State | GA
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