Provider Demographics
NPI:1376196147
Name:HOPEWORKS WELLNESS, LLC
Entity Type:Organization
Organization Name:HOPEWORKS WELLNESS, LLC
Other - Org Name:HOPEWORKS WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:
Authorized Official - Last Name:JEAN-JACQUES
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:267-704-9375
Mailing Address - Street 1:3850 WOODHAVEN RD # HOUSE804
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19154-2730
Mailing Address - Country:US
Mailing Address - Phone:267-704-9375
Mailing Address - Fax:
Practice Address - Street 1:2449 GOLF RD STE 2
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-1475
Practice Address - Country:US
Practice Address - Phone:267-704-9375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-22
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health