Provider Demographics
NPI:1093523342
Name:NEW HOPE RESTORATION COUNSELING LLC
Entity type:Organization
Organization Name:NEW HOPE RESTORATION COUNSELING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROCKAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LCPC, NCC
Authorized Official - Phone:618-530-1094
Mailing Address - Street 1:1221 MERRIAM PKWY
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:IL
Mailing Address - Zip Code:62269-7087
Mailing Address - Country:US
Mailing Address - Phone:618-530-1094
Mailing Address - Fax:
Practice Address - Street 1:4972 BENCHMARK CENTRE DR STE 100
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:IL
Practice Address - Zip Code:62226-2070
Practice Address - Country:US
Practice Address - Phone:618-494-3064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty