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General NPI Number Information
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NPI Number | 1811604838
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Entity Type | Organization
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Legal Business Name | TRAUMA TO HOPE COUNSELING CORP
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Dates
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Enumeration Date | 10/31/2022
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Last Update Date | 09/05/2023
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Provider Practice Location Address
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Address Line | 165 MAIN ST UNIT 303
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City | MEDWAY
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State | MA
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Zip | 02053-1584
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Country | US
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Telephone | 617-903-0158
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Fax |
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Provider Business Mailing Address
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Address Line | 165 MAIN ST UNIT 303
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City | MEDWAY
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State | MA
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Zip | 02053-1584
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Country | US
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Telephone | 617-903-0158
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Fax |
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Authorized Official
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Title or Position | INDEPENDENT LICENSE SOCIAL WORKER
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Name | LUBENJI D LAFOREST
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Credential |
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Telephone | 617-903-0158
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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 |
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License Number State |
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