Provider Demographics
NPI:1770028300
Name:GOOD HOPE COUNSELING PC
Entity Type:Organization
Organization Name:GOOD HOPE COUNSELING PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:TUMBORELLO LCSW CADC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-350-8456
Mailing Address - Street 1:2200 S MAIN ST STE 303
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-5366
Mailing Address - Country:US
Mailing Address - Phone:773-350-8456
Mailing Address - Fax:
Practice Address - Street 1:2200 S MAIN ST STE 303
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-5366
Practice Address - Country:US
Practice Address - Phone:773-350-8456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANNE TUMBORELLO LCSW CADC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-01-06
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0155271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty