MEDICARE: HOPEFUL SOLUTIONS COUNSELING PLLC

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	106H00000X	Marriage & Family Therapist	106483	KY
2	101YM0800X	Mental Health Counselor	102108	KY
3	163WP0808X	Psychiatric/Mental Health Registered Nurse	1031647	KY
4	101YM0800X	Mental Health Counselor	103821	KY

General Provider Information

NPI Number	:	1538603550
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOPEFUL SOLUTIONS COUNSELING PLLC

Provider Business Mailing Address
First Line	:	1105 JULIANNA CT
Second Line	:	STE 1
City	:	ELIZABETHTOWN
State	:	KY
Zip	:	42701-7937
Country	:	US
Telephone Number	:	270-769-3714
Fax Number	:	270-769-0335

Provider Business Practice Location Address
First Line	:	1105 JULIANNA CT
Second Line	:	STE 1
City	:	ELIZABETHTOWN
State	:	KY
Zip	:	42701-7937
Country	:	US
Telephone Number	:	270-769-3714
Fax Number	:	270-769-0335

Authorized Official
Title or Position	:	OWNER
Name	:	MS. CHANIN MICHELLE BROWN
Credential	:	LPCC
Telephone Number	:	270-769-3714

Provider Enumeration Date	:	12/09/2016
Last Update Date	:	12/09/2016

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