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General NPI Number Information
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NPI Number | 1720350705
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Entity Type | Organization
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Legal Business Name | NEW HOPE INTERVENTION, LLC
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Dates
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Enumeration Date | 02/06/2012
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Last Update Date | 02/06/2012
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Provider Practice Location Address
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Address Line | 1114 THOMASVILLE RD SUITE E5
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City | TALLAHASSEE
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State | FL
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Zip | 32303-6288
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Country | US
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Telephone | 850-270-9686
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Fax | 850-270-9688
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Provider Business Mailing Address
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Address Line | 1114 THOMASVILLE RD SUITE E5
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City | TALLAHASSEE
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State | FL
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Zip | 32303-6288
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Country | US
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Telephone | 850-270-9686
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Fax | 850-270-9688
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Authorized Official
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Title or Position | OWNER/DIRECTOR/THERAPIST
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Name | MRS. MILEYA DANYELLE STOREY
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Credential | LCSW
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Telephone | 850-270-9686
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW9426
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License Number State | FL
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