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General NPI Number Information
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NPI Number | 1942471529
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Entity Type | Organization
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Legal Business Name | HOPE - CHILD AND FAMILY COUNSELING INC
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Dates
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Enumeration Date | 03/21/2008
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 11447 2ND ST STE 9B
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City | ROSCOE
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State | IL
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Zip | 61073-9522
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Country | US
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Telephone | 815-601-4673
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Fax | 866-303-8062
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Provider Business Mailing Address
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Address Line | 11447 2ND ST STE 9B
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City | ROSCOE
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State | IL
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Zip | 61073-9522
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Country | US
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Telephone | 815-601-4673
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Fax | 866-303-8062
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Authorized Official
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Title or Position | OWNER
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Name | JAMIE RENEE WAGNER
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Credential | LCPC
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Telephone | 815-601-4673
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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 | 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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Taxonomy #4
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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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Taxonomy #5
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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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 | 180033993
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License Number State | IL
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