Provider Demographics
NPI:1427532647
Name:HOPE BASED COUNSELING, LLC
Entity type:Organization
Organization Name:HOPE BASED COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:JAEGER
Authorized Official - Suffix:
Authorized Official - Credentials:MA LPCC
Authorized Official - Phone:763-639-9774
Mailing Address - Street 1:9803 VAGABOND LN N
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55311-1364
Mailing Address - Country:US
Mailing Address - Phone:763-639-9774
Mailing Address - Fax:
Practice Address - Street 1:7200 FORESTVIEW LN N
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-5571
Practice Address - Country:US
Practice Address - Phone:763-639-9774
Practice Address - Fax:844-691-5933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-24
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty