Provider Demographics
NPI:1588223127
Name:HOPE UNBRIDLED COUNSEING LLC
Entity Type:Organization
Organization Name:HOPE UNBRIDLED COUNSEING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:V
Authorized Official - Last Name:TIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:662-540-5558
Mailing Address - Street 1:2639 OAKCREST DR
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38804-8003
Mailing Address - Country:US
Mailing Address - Phone:662-540-5558
Mailing Address - Fax:
Practice Address - Street 1:1018 N GLOSTER ST STE F
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804-1234
Practice Address - Country:US
Practice Address - Phone:662-540-5558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-07
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty