Provider Demographics
NPI:1346938164
Name:SEEDS OF HOPE COUNSELING SERVICE LLC
Entity Type:Organization
Organization Name:SEEDS OF HOPE COUNSELING SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LORISA
Authorized Official - Middle Name:
Authorized Official - Last Name:EBY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:224-577-9203
Mailing Address - Street 1:3854 SOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-5285
Mailing Address - Country:US
Mailing Address - Phone:417-215-2818
Mailing Address - Fax:
Practice Address - Street 1:3854 SOUTH AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-5285
Practice Address - Country:US
Practice Address - Phone:417-215-2818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-28
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty