MEDICARE: RESTORING HOPE COUNSELING 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	251B00000X	Case Management Agency
2	101Y00000X	Counselor

General Provider Information

NPI Number	:	1952117798
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESTORING HOPE COUNSELING SERVICES LLC

Provider Business Mailing Address
First Line	:	1019 10TH ST NW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44703-3380
Country	:	US
Telephone Number	:	330-861-2444
Fax Number	:

Provider Business Practice Location Address
First Line	:	1435 MARKET AVE N
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44714-2609
Country	:	US
Telephone Number	:	330-861-2444
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TONYA WATTS
Credential	:	LPCC-S
Telephone Number	:	330-861-2444

Provider Enumeration Date	:	12/06/2024
Last Update Date	:	12/06/2024

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