MEDICARE: HEAL AND HOPE COUNSELING SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	101YM0800X	Mental Health Counselor
3	101Y00000X	Counselor
4	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1649830423
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEAL AND HOPE COUNSELING SERVICES LLC

Provider Business Mailing Address
First Line	:	241 LAKEWOOD CIRCLE DR
Second Line	:
City	:	DECATUR
State	:	TN
Zip	:	37322-8243
Country	:	US
Telephone Number	:	423-790-4906
Fax Number	:

Provider Business Practice Location Address
First Line	:	1510 STUART RD NE STE 101
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37312-5869
Country	:	US
Telephone Number	:	423-790-4906
Fax Number	:	423-790-7074

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	STEPHEN M CONDON
Credential	:
Telephone Number	:	423-790-4906

Provider Enumeration Date	:	06/14/2019
Last Update Date	:	08/14/2024

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