Provider Demographics
NPI:1275079162
Name:HEARTLAND HOPE COUNSELING, LLC
Entity Type:Organization
Organization Name:HEARTLAND HOPE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:EDRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPCC
Authorized Official - Phone:270-283-4259
Mailing Address - Street 1:112 ROBERTS RD
Mailing Address - Street 2:UNIT 4
Mailing Address - City:CAMPBELLSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42718-1593
Mailing Address - Country:US
Mailing Address - Phone:270-283-4259
Mailing Address - Fax:
Practice Address - Street 1:112 ROBERTS RD
Practice Address - Street 2:UNIT 4
Practice Address - City:CAMPBELLSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42718-1593
Practice Address - Country:US
Practice Address - Phone:270-283-4259
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-16
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty