Provider Demographics
NPI:1235569559
Name:RESTORED HOPE COUNSELING, LLC
Entity Type:Organization
Organization Name:RESTORED HOPE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:TAWNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPEER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-799-5556
Mailing Address - Street 1:801 PILE ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88101-6643
Mailing Address - Country:US
Mailing Address - Phone:575-935-4202
Mailing Address - Fax:
Practice Address - Street 1:801 PILE ST
Practice Address - Street 2:SUITE 202
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-6643
Practice Address - Country:US
Practice Address - Phone:575-935-4202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-22
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0146681101YM0800X
NM1-06006104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty