Provider Demographics
NPI:1811575426
Name:BEACON OF HOPE COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:BEACON OF HOPE COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/OWNER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:COLBURN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC, CCTP
Authorized Official - Phone:480-826-8865
Mailing Address - Street 1:2222 S DOBSON RD STE 301
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-6490
Mailing Address - Country:US
Mailing Address - Phone:480-581-0320
Mailing Address - Fax:480-581-0321
Practice Address - Street 1:2222 S DOBSON RD STE 301
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-6490
Practice Address - Country:US
Practice Address - Phone:480-581-0320
Practice Address - Fax:480-581-0321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-02
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty