Provider Demographics
NPI:1124615349
Name:SEEDS OF HOPE THERAPY, LLC
Entity type:Organization
Organization Name:SEEDS OF HOPE THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEAHANNA
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:314-648-1021
Mailing Address - Street 1:1120 FREEDOM DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042-7467
Mailing Address - Country:US
Mailing Address - Phone:931-220-9504
Mailing Address - Fax:
Practice Address - Street 1:1120 FREEDOM DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37042-7467
Practice Address - Country:US
Practice Address - Phone:931-220-9504
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty