MEDICARE: HOPE & OUTREACH THERAPY SERVICES, 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	:	1932679016
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOPE & OUTREACH THERAPY SERVICES, LLC

Provider Business Mailing Address
First Line	:	275 4TH ST E STE 555
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55101-2538
Country	:	US
Telephone Number	:	651-605-6370
Fax Number	:

Provider Business Practice Location Address
First Line	:	275 4TH ST E STE 555
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55101-2538
Country	:	US
Telephone Number	:	651-605-6370
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JESSICA ROSE CYLKOWSKI
Credential	:	LICSW
Telephone Number	:	651-605-6370

Provider Enumeration Date	:	11/30/2018
Last Update Date	:	04/25/2024

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