Provider Demographics
NPI:1417684911
Name:SEEDS OF HOPE CLINICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:SEEDS OF HOPE CLINICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:JANEAN
Authorized Official - Last Name:SEEDS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:512-771-9766
Mailing Address - Street 1:155 HILLCREST LN STE B
Mailing Address - Street 2:
Mailing Address - City:LIBERTY HILL
Mailing Address - State:TX
Mailing Address - Zip Code:78642-4435
Mailing Address - Country:US
Mailing Address - Phone:512-771-9766
Mailing Address - Fax:
Practice Address - Street 1:155 HILLCREST LN STE B
Practice Address - Street 2:
Practice Address - City:LIBERTY HILL
Practice Address - State:TX
Practice Address - Zip Code:78642-4435
Practice Address - Country:US
Practice Address - Phone:512-771-9766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)