Provider Demographics
NPI:1386837938
Name:H.O.P.E. COUNSELING SERVICES
Entity Type:Organization
Organization Name:H.O.P.E. COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LEAD THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:KATHLEEN
Authorized Official - Last Name:LICHTENWALTER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PHD
Authorized Official - Phone:765-364-0380
Mailing Address - Street 1:1984 INDIANAPOLIS RD
Mailing Address - Street 2:
Mailing Address - City:CRAWFORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47933-3135
Mailing Address - Country:US
Mailing Address - Phone:765-364-0380
Mailing Address - Fax:765-364-6816
Practice Address - Street 1:1984 INDIANAPOLIS RD
Practice Address - Street 2:
Practice Address - City:CRAWFORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47933-3135
Practice Address - Country:US
Practice Address - Phone:765-364-0380
Practice Address - Fax:765-364-6816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1410-0-ASO251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1326104001Medicaid
IN212540UMedicare PIN