Provider Demographics
NPI: | 1396396230 |
---|---|
Name: | PURSUING HOPE COUNSELING, LLC |
Entity Type: | Organization |
Organization Name: | PURSUING HOPE COUNSELING, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | THERAPIST |
Authorized Official - Prefix: | |
Authorized Official - First Name: | NICOLLE |
Authorized Official - Middle Name: | ELIZABETH |
Authorized Official - Last Name: | WARGO |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LPC |
Authorized Official - Phone: | 860-967-4627 |
Mailing Address - Street 1: | 30 MANSE HILL RD |
Mailing Address - Street 2: | |
Mailing Address - City: | SOMERS |
Mailing Address - State: | CT |
Mailing Address - Zip Code: | 06071-1544 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 860-967-4627 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 27 HARTFORD TPKE |
Practice Address - Street 2: | |
Practice Address - City: | VERNON |
Practice Address - State: | CT |
Practice Address - Zip Code: | 06066-5245 |
Practice Address - Country: | US |
Practice Address - Phone: | 860-967-4627 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2019-09-23 |
Last Update Date: | 2019-09-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
No | 251S00000X | Agencies | Community/Behavioral Health |