Provider Demographics
NPI:1457858193
Name:CENTER OF HOPE TREATMENT OF ATTACHMENT & TRAUMA LLC
Entity Type:Organization
Organization Name:CENTER OF HOPE TREATMENT OF ATTACHMENT & TRAUMA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:P
Authorized Official - Last Name:SHERFEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:423-340-1270
Mailing Address - Street 1:204 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:TN
Mailing Address - Zip Code:37620-1704
Mailing Address - Country:US
Mailing Address - Phone:423-968-2225
Mailing Address - Fax:423-573-2226
Practice Address - Street 1:204 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-1704
Practice Address - Country:US
Practice Address - Phone:423-968-2225
Practice Address - Fax:423-573-2226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-10
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN47131041C0700X
VA09040061451041C0700X
261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty