Provider Demographics
NPI:1285776880
Name:HOPE & HEALING COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:HOPE & HEALING COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:732-616-4250
Mailing Address - Street 1:PO BOX 1198
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-0255
Mailing Address - Country:US
Mailing Address - Phone:732-616-4250
Mailing Address - Fax:732-364-7602
Practice Address - Street 1:103 W 2ND ST
Practice Address - Street 2:SUITE 5
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-8515
Practice Address - Country:US
Practice Address - Phone:732-534-5375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00307800101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0057134Medicaid