Provider Demographics
NPI:1215784962
Name:DIVINE HOPE COUNSELING & ASSESSMENT SERVICES
Entity type:Organization
Organization Name:DIVINE HOPE COUNSELING & ASSESSMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CASEREA
Authorized Official - Middle Name:NIKKOL
Authorized Official - Last Name:TOWNSEND
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:901-207-0223
Mailing Address - Street 1:215 LAKEWAY DR
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-6814
Mailing Address - Country:US
Mailing Address - Phone:901-207-0223
Mailing Address - Fax:
Practice Address - Street 1:215 LAKEWAY DR
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-6814
Practice Address - Country:US
Practice Address - Phone:901-207-0223
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)