MEDICARE: HALLS ANCHOR OF HOPE

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1235885898
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HALLS ANCHOR OF HOPE

Provider Business Mailing Address
First Line	:	4416 W HOUSTON ST
Second Line	:
City	:	BROKEN ARROW
State	:	OK
Zip	:	74012-4645
Country	:	US
Telephone Number	:	918-288-0027
Fax Number	:

Provider Business Practice Location Address
First Line	:	4416 W HOUSTON ST
Second Line	:
City	:	BROKEN ARROW
State	:	OK
Zip	:	74012
Country	:	US
Telephone Number	:	918-288-0027
Fax Number	:	918-304-6080

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. AMANDA K HALL
Credential	:	LPC
Telephone Number	:	918-288-0027

Provider Enumeration Date	:	02/22/2022
Last Update Date	:	10/03/2024

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