Provider Demographics
NPI:1033974563
Name:PERSEVERANT HOPE COUNSELING PLLC
Entity Type:Organization
Organization Name:PERSEVERANT HOPE COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MARRIAGE AND FAMILY THERAP
Authorized Official - Prefix:
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:716-359-6031
Mailing Address - Street 1:109 MARION CORNETT RD
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-7303
Mailing Address - Country:US
Mailing Address - Phone:716-359-6031
Mailing Address - Fax:
Practice Address - Street 1:109 MARION CORNETT RD
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-7303
Practice Address - Country:US
Practice Address - Phone:716-359-6031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)