MEDICARE: HOPE RESOURCES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC1900X	Counseling Psychologist

General Provider Information

NPI Number	:	1144702507
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOPE RESOURCES LLC

Provider Business Mailing Address
First Line	:	760 DALEROSE AVENUE
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30030
Country	:	US
Telephone Number	:	404-965-5843
Fax Number	:

Provider Business Practice Location Address
First Line	:	814 JUNIPER ST NE STE 201
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30308-1300
Country	:	US
Telephone Number	:	404-965-5843
Fax Number	:

Authorized Official
Title or Position	:	OWNER/LICENSED PSYCHOLOGIST
Name	:	DR. KATHRYN BRYAN
Credential	:	PHD, MDIV
Telephone Number	:	404-965-5843

Provider Enumeration Date	:	09/02/2018
Last Update Date	:	09/25/2019

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Directions to “HOPE RESOURCES LLC ” Practice Location

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