MEDICARE: THERAPEUTIC 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	MH12907	FL

General Provider Information

NPI Number	:	1467831594
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERAPEUTIC HOPE

Provider Business Mailing Address
First Line	:	3750 OCEANSIDE ST
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34286-1981
Country	:	US
Telephone Number	:	941-914-5168
Fax Number	:

Provider Business Practice Location Address
First Line	:	3750 OCEANSIDE ST
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34286-1981
Country	:	US
Telephone Number	:	941-914-5168
Fax Number	:

Authorized Official
Title or Position	:	LMHC
Name	:	RACHAEL A TRIPPETT
Credential	:	LMHC
Telephone Number	:	941-914-5168

Provider Enumeration Date	:	05/21/2015
Last Update Date	:	05/21/2015

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Directions to “THERAPEUTIC HOPE ” Practice Location

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