Provider Demographics
NPI:1083490114
Name:HOPE UNLIMITED COUNSEL FOR CHRISTIAN LIVING, LLC
Entity Type:Organization
Organization Name:HOPE UNLIMITED COUNSEL FOR CHRISTIAN LIVING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CORY
Authorized Official - Middle Name:JUSTIN
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:325-246-9121
Mailing Address - Street 1:1219 E BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:SWEETWATER
Mailing Address - State:TX
Mailing Address - Zip Code:79556-4719
Mailing Address - Country:US
Mailing Address - Phone:325-246-9121
Mailing Address - Fax:
Practice Address - Street 1:1219 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:SWEETWATER
Practice Address - State:TX
Practice Address - Zip Code:79556-4719
Practice Address - Country:US
Practice Address - Phone:325-246-9121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-05
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4314676Medicaid