Provider Demographics
NPI:1639435829
Name:RESTORING HOPE COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:RESTORING HOPE COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUBRINA
Authorized Official - Middle Name:L
Authorized Official - Last Name:RUSH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:678-622-7973
Mailing Address - Street 1:5300 MEMORIAL DR
Mailing Address - Street 2:SUITE 208B
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083-3148
Mailing Address - Country:US
Mailing Address - Phone:678-622-7973
Mailing Address - Fax:770-507-7695
Practice Address - Street 1:5300 MEMORIAL DR
Practice Address - Street 2:SUITE 208B
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083-3148
Practice Address - Country:US
Practice Address - Phone:678-622-7973
Practice Address - Fax:770-507-7695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-02
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004530251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health