Provider Demographics
NPI:1932570819
Name:ANCHOR OF HOPE COUNSELING, LLC
Entity type:Organization
Organization Name:ANCHOR OF HOPE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:LANTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-805-0953
Mailing Address - Street 1:36 W 8TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-2701
Mailing Address - Country:US
Mailing Address - Phone:616-805-0953
Mailing Address - Fax:616-805-0954
Practice Address - Street 1:36 W 8TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-2701
Practice Address - Country:US
Practice Address - Phone:616-805-0953
Practice Address - Fax:616-805-0954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-16
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401012526101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty