Provider Demographics
NPI:1083100960
Name:HOPE AND HEALING COUNSELING SUPPORT LLC
Entity type:Organization
Organization Name:HOPE AND HEALING COUNSELING SUPPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:FREDERIKSEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:248-840-9517
Mailing Address - Street 1:29501 GREENFIELD RD STE 120
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-5869
Mailing Address - Country:US
Mailing Address - Phone:248-794-0550
Mailing Address - Fax:
Practice Address - Street 1:29501 GREENFIELD RD STE 120
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-5869
Practice Address - Country:US
Practice Address - Phone:248-794-0550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-03
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty