Provider Demographics
NPI:1720598592
Name:NEW HOPE COUNSELING AND RECOVERY
Entity Type:Organization
Organization Name:NEW HOPE COUNSELING AND RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:LAKES
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:606-658-9775
Mailing Address - Street 1:60 BENNETT CIRCLE
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40741-2842
Mailing Address - Country:US
Mailing Address - Phone:606-658-9775
Mailing Address - Fax:606-658-9778
Practice Address - Street 1:60 BENNETT CIRCLE
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-2842
Practice Address - Country:US
Practice Address - Phone:606-658-9775
Practice Address - Fax:606-658-9778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-06
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0224101YM0800X, 101YP2500X
101YM0800X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1316303654Medicaid
KY7100508530Medicaid