Provider Demographics
NPI:1073791240
Name:VISION OF HOPE MARRIAGE & FAMILY THERAPY, LLC
Entity Type:Organization
Organization Name:VISION OF HOPE MARRIAGE & FAMILY THERAPY, LLC
Other - Org Name:VISION OF HOPE COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARISOL
Authorized Official - Middle Name:
Authorized Official - Last Name:PERSAUD
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:516-285-1165
Mailing Address - Street 1:30 S CENTRAL AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-5414
Mailing Address - Country:US
Mailing Address - Phone:516-285-1165
Mailing Address - Fax:516-285-1165
Practice Address - Street 1:30 S CENTRAL AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-5414
Practice Address - Country:US
Practice Address - Phone:516-285-1165
Practice Address - Fax:516-285-1165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-09
Last Update Date:2008-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000164-1106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty