Provider Demographics
NPI:1285032003
Name:CIRCLE OF HOPE, LLC
Entity Type:Organization
Organization Name:CIRCLE OF HOPE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:DUCKWORTH
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:504-722-8267
Mailing Address - Street 1:401 WHITNEY AVE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056-2558
Mailing Address - Country:US
Mailing Address - Phone:504-722-8267
Mailing Address - Fax:504-345-2035
Practice Address - Street 1:401 WHITNEY AVE
Practice Address - Street 2:SUITE 306
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-2558
Practice Address - Country:US
Practice Address - Phone:504-722-8267
Practice Address - Fax:504-345-2035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-10
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2809101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty