Provider Demographics
NPI:1306186382
Name:RESTORING HOPE CONSULTING AND SOCIAL WORK, P.A.
Entity Type:Organization
Organization Name:RESTORING HOPE CONSULTING AND SOCIAL WORK, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:REBEKAH
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:479-647-9728
Mailing Address - Street 1:PO BOX 142
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72811-0142
Mailing Address - Country:US
Mailing Address - Phone:479-647-9728
Mailing Address - Fax:
Practice Address - Street 1:116 S FRONT ST
Practice Address - Street 2:
Practice Address - City:DARDANELLE
Practice Address - State:AR
Practice Address - Zip Code:72834-4028
Practice Address - Country:US
Practice Address - Phone:479-647-9728
Practice Address - Fax:866-389-8845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-27
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR5873-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARUNKNOWNMedicaid
AR1306186382Medicaid
AR1306186382Medicaid