Provider Demographics
NPI:1508340282
Name:CHARITY FAITH & HOPE COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:CHARITY FAITH & HOPE COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ LEAD CLINICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:OPHELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACKWELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCPC
Authorized Official - Phone:785-236-5059
Mailing Address - Street 1:841 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:JUNCTION CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66441-3803
Mailing Address - Country:US
Mailing Address - Phone:785-236-5059
Mailing Address - Fax:
Practice Address - Street 1:841 S WASHINGTON ST STE A
Practice Address - Street 2:
Practice Address - City:JUNCTION CITY
Practice Address - State:KS
Practice Address - Zip Code:66441-3803
Practice Address - Country:US
Practice Address - Phone:785-236-5059
Practice Address - Fax:888-447-8231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty