Provider Demographics
NPI:1730678707
Name:HOPE TO HEALING COUNSELING CENTER, LLC
Entity Type:Organization
Organization Name:HOPE TO HEALING COUNSELING CENTER, LLC
Other - Org Name:HOPE TO HEALING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:L
Authorized Official - Last Name:FARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:402-995-9341
Mailing Address - Street 1:3715 N 104TH AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-3790
Mailing Address - Country:US
Mailing Address - Phone:402-995-9341
Mailing Address - Fax:855-940-6026
Practice Address - Street 1:3707 N 108TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68164-2940
Practice Address - Country:US
Practice Address - Phone:402-995-9341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-05
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)