Provider Demographics
NPI:1215479373
Name:BRANCH OF HOPE COUNSELING, LLC
Entity type:Organization
Organization Name:BRANCH OF HOPE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-CP
Authorized Official - Phone:864-300-4968
Mailing Address - Street 1:110 HOSPITAL DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-3226
Mailing Address - Country:US
Mailing Address - Phone:864-300-4968
Mailing Address - Fax:864-757-9951
Practice Address - Street 1:110 HOSPITAL DR
Practice Address - Street 2:SUITE B
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-3226
Practice Address - Country:US
Practice Address - Phone:864-300-4968
Practice Address - Fax:864-757-9951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-07
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC100931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC7000243533OtherSOUTH CAROLINA STATE PROCUREMENT OFFICE, SC STATE GOVERNMENT VENDER DATABASE