MEDICARE: HOPEFUL HEALING 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	:	1922714690
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOPEFUL HEALING LLC

Provider Business Mailing Address
First Line	:	1753 E BROADWAY RD STE 101-430
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-1589
Country	:	US
Telephone Number	:	480-420-7083
Fax Number	:

Provider Business Practice Location Address
First Line	:	3707 E SOUTHERN AVE STE 2028
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85206-6214
Country	:	US
Telephone Number	:	480-420-7083
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MAEGAN L CRONIN
Credential	:	LCSW
Telephone Number	:	480-420-7083

Provider Enumeration Date	:	01/26/2023
Last Update Date	:	01/26/2023

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