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General NPI Number Information
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NPI Number | 1750621488
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Entity Type | Organization
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Legal Business Name | HOPE FOR LIFE
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Dates
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Enumeration Date | 02/16/2013
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Last Update Date | 02/16/2013
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Provider Practice Location Address
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Address Line | 235 S LAKEWOOD ST
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City | PENNINGTON GAP
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State | VA
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Zip | 24277-2039
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Country | US
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Telephone | 276-639-5710
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Fax |
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Provider Business Mailing Address
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Address Line | 235 S LAKEWOOD ST
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City | PENNINGTON GAP
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State | VA
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Zip | 24277-2039
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Country | US
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Telephone | 276-639-5710
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Fax |
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Authorized Official
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Title or Position | THERAPIST/DIRECTOR
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Name | MS. KIM L LAWSON
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Credential | M.ED, LPC, LPCC, NCC
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Telephone | 276-639-5710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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