Provider Demographics
NPI:1194359836
Name:HOPE PROFESSIONAL COUNSELING SERVICES
Entity Type:Organization
Organization Name:HOPE PROFESSIONAL COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED PROFESSIONAL COUNSEL
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:MEZZA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:678-978-0464
Mailing Address - Street 1:12598 BROOKCHASE LN
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-6203
Mailing Address - Country:US
Mailing Address - Phone:678-978-0464
Mailing Address - Fax:800-616-1875
Practice Address - Street 1:308 NIGHT FALL TER
Practice Address - Street 2:
Practice Address - City:VILLA RICA
Practice Address - State:GA
Practice Address - Zip Code:30180-7724
Practice Address - Country:US
Practice Address - Phone:678-978-0464
Practice Address - Fax:800-616-1875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-02
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty