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General NPI Number Information
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NPI Number | 1629418199
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Entity Type | Organization
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Legal Business Name | HOPE COUNSELING CENTER LLC
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Dates
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Enumeration Date | 06/28/2013
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Last Update Date | 06/28/2013
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Provider Practice Location Address
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Address Line | 558 LAKE PARK DR
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City | VALPARAISO
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State | IN
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Zip | 46385-8818
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Country | US
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Telephone | 219-309-9306
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Fax |
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Provider Business Mailing Address
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Address Line | 558 LAKE PARK DRIVE
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City | VALPARAISO
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State | IN
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Zip | 46385
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Country | US
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Telephone | 219-309-9306
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR/OWNER
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Name | DR. LYNETTE SCHULTZ
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Credential | PSYD., H.S.P.P.
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Telephone | 219-309-9306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 20042525A
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License Number State | IN
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