Provider Demographics
NPI:1598206856
Name:HOPE VIRTUAL COUNSELING & THERAPY
Entity Type:Organization
Organization Name:HOPE VIRTUAL COUNSELING & THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC, LMHC
Authorized Official - Prefix:
Authorized Official - First Name:ROCHELY
Authorized Official - Middle Name:
Authorized Official - Last Name:TERRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-919-7879
Mailing Address - Street 1:815 N HOMESTEAD BLVD STE 228
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-5024
Mailing Address - Country:US
Mailing Address - Phone:478-783-4374
Mailing Address - Fax:478-783-4374
Practice Address - Street 1:1551 FLAMINGO CT
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33035-1024
Practice Address - Country:US
Practice Address - Phone:478-919-7879
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-20
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC008877101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL022169800Medicaid