MEDICARE: HOPE TO HEAL COUNSELING CENTER 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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1639952054
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOPE TO HEAL COUNSELING CENTER LLC

Provider Business Mailing Address
First Line	:	PO BOX 1298
Second Line	:
City	:	WEST SPRINGFIELD
State	:	MA
Zip	:	01090-1298
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1029 NORTH RD STE 4
Second Line	:
City	:	WESTFIELD
State	:	MA
Zip	:	01085-9714
Country	:	US
Telephone Number	:	413-575-4777
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NILSA L FELIX
Credential	:	LICSW
Telephone Number	:	787-203-0256

Provider Enumeration Date	:	08/17/2023
Last Update Date	:	08/17/2023

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