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General NPI Number Information
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NPI Number | 1982300406
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Entity Type | Organization
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Legal Business Name | THE PLACE OF HOPE, PLLC
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Dates
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Enumeration Date | 02/06/2023
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Last Update Date | 02/06/2023
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Provider Practice Location Address
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Address Line | 6508 WAYSIDE PL
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City | ALEXANDRIA
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State | VA
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Zip | 22310-2864
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Country | US
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Telephone | 703-785-4512
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Fax |
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Provider Business Mailing Address
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Address Line | 6508 WAYSIDE PL
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City | ALEXANDRIA
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State | VA
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Zip | 22310-2864
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Country | US
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Telephone | 703-785-4512
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Fax |
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Authorized Official
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Title or Position | LPC
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Name | LILLIAN MAE JENKINS
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Credential | OWNER
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Telephone | 703-495-3651
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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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