Provider Demographics
NPI:1578005690
Name:COUNSELING FOR RESTORED HOPE LCSW, P.L.L.C.
Entity Type:Organization
Organization Name:COUNSELING FOR RESTORED HOPE LCSW, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:HOTVET
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:518-441-5660
Mailing Address - Street 1:421 NEW KARNER RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-3861
Mailing Address - Country:US
Mailing Address - Phone:518-441-5660
Mailing Address - Fax:518-689-6869
Practice Address - Street 1:421 NEW KARNER RD
Practice Address - Street 2:SUITE 2
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-3861
Practice Address - Country:US
Practice Address - Phone:518-441-5660
Practice Address - Fax:518-689-6869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0823881041C0700X
NYR0711801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04319595Medicaid