Provider Demographics
NPI:1710588207
Name:HOPE FAMILY THERAPY AND CONSULTATION SERVICES, LLC
Entity Type:Organization
Organization Name:HOPE FAMILY THERAPY AND CONSULTATION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:O
Authorized Official - Last Name:ADEGBOLA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCSW
Authorized Official - Phone:609-576-2221
Mailing Address - Street 1:1 LIGHTHOUSE CT
Mailing Address - Street 2:
Mailing Address - City:EASTAMPTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-4431
Mailing Address - Country:US
Mailing Address - Phone:609-576-2221
Mailing Address - Fax:
Practice Address - Street 1:1 LIGHTHOUSE CT
Practice Address - Street 2:
Practice Address - City:EASTAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08060-4431
Practice Address - Country:US
Practice Address - Phone:609-576-2221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-03
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty