Provider Demographics
NPI:1487460135
Name:HOPE HOUSE PSYCHOLOGICAL SERVICES, LLC
Entity type:Organization
Organization Name:HOPE HOUSE PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRISTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SEALEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:850-312-8055
Mailing Address - Street 1:14101 PANAMA CITY BEACH PKWY STE 410
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32413-2871
Mailing Address - Country:US
Mailing Address - Phone:850-312-8055
Mailing Address - Fax:
Practice Address - Street 1:14101 PANAMA CITY BEACH PKWY STE 410
Practice Address - Street 2:
Practice Address - City:PANAMA CITY BEACH
Practice Address - State:FL
Practice Address - Zip Code:32413-2871
Practice Address - Country:US
Practice Address - Phone:850-312-8055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-07
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty