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General NPI Number Information
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NPI Number | 1730678707
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Entity Type | Organization
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Legal Business Name | HOPE TO HEALING COUNSELING CENTER, LLC
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Dates
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Enumeration Date | 05/05/2018
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 3661 N 129TH ST
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City | OMAHA
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State | NE
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Zip | 68164-5211
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Country | US
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Telephone | 531-867-3052
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Fax | 855-940-6026
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Provider Business Mailing Address
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Address Line | 3661 N 129TH ST
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City | OMAHA
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State | NE
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Zip | 68164-5211
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Country | US
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Telephone | 531-867-3052
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Fax | 855-940-6026
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | JACQUELINE L FARRIS
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Credential | PH.D.
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Telephone | 531-867-3052
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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