Provider Demographics
NPI:1659505394
Name:HOPE PSYCHOTHERAPY LLC
Entity Type:Organization
Organization Name:HOPE PSYCHOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:G
Authorized Official - Last Name:MONROY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:888-695-9740
Mailing Address - Street 1:31070 HARBOR LN
Mailing Address - Street 2:
Mailing Address - City:PAINTER
Mailing Address - State:VA
Mailing Address - Zip Code:23420-3119
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4099 FOXWOOD DR
Practice Address - Street 2:SUITE 203
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-5222
Practice Address - Country:US
Practice Address - Phone:888-695-9740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-10
Last Update Date:2009-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)