MEDICARE: H.O.P.E BEHAVIORAL HEALTH

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	:	1275198475
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	H.O.P.E BEHAVIORAL HEALTH

Provider Business Mailing Address
First Line	:	3261 OLD WASHINGTON RD STE 3021
Second Line	:
City	:	WALDORF
State	:	MD
Zip	:	20602-3229
Country	:	US
Telephone Number	:	240-579-5658
Fax Number	:

Provider Business Practice Location Address
First Line	:	3261 OLD WASHINGTON RD STE 3021
Second Line	:
City	:	WALDORF
State	:	MD
Zip	:	20602-3229
Country	:	US
Telephone Number	:	240-579-5658
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	TAMEKA PRICE
Credential	:	LCSW-C
Telephone Number	:	240-579-5658

Provider Enumeration Date	:	05/03/2019
Last Update Date	:	05/03/2019

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