Provider Demographics
NPI:1417316068
Name:HOPE HEALS THERAPY LLC
Entity Type:Organization
Organization Name:HOPE HEALS THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ANUSREE
Authorized Official - Middle Name:
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPC, NCC
Authorized Official - Phone:512-887-8033
Mailing Address - Street 1:16109 DOUBLE EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78717-3815
Mailing Address - Country:US
Mailing Address - Phone:512-887-8033
Mailing Address - Fax:914-940-1098
Practice Address - Street 1:111 W ANDERSON LN
Practice Address - Street 2:STE D197
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78752-1132
Practice Address - Country:US
Practice Address - Phone:512-887-8033
Practice Address - Fax:914-940-1098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-10
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67242101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty