Provider Demographics
NPI:1093574436
Name:SEASONS OF HOPE AND HEALING, LLC
Entity Type:Organization
Organization Name:SEASONS OF HOPE AND HEALING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TRACIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MAILLE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:484-509-1079
Mailing Address - Street 1:1521 CEDAR CLIFF DR STE 200
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-7706
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1521 CEDAR CLIFF DR STE 200
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-7706
Practice Address - Country:US
Practice Address - Phone:484-509-1079
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty