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General NPI Number Information
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NPI Number | 1801619200
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Entity Type | Organization
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Legal Business Name | COMMITMENT TO HOPE MENTAL HEALTH COUNSELING CENTER LLC
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 1460 ROCKEFELLER RD
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City | WICKLIFFE
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State | OH
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Zip | 44092-1932
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Country | US
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Telephone | 440-799-7559
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Fax |
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Provider Business Mailing Address
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Address Line | 1460 ROCKEFELLER RD
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City | WICKLIFFE
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State | OH
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Zip | 44092-1932
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Country | US
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Telephone | 440-799-7559
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | GWENETTE MAURELL JAMES
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Credential | LISW
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Telephone | 440-799-7559
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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