Provider Demographics
NPI:1861044406
Name:HOPE FAMILY COUNSELING
Entity Type:Organization
Organization Name:HOPE FAMILY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION/LMHC
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:641-351-2788
Mailing Address - Street 1:PO BOX 133
Mailing Address - Street 2:
Mailing Address - City:LE GRAND
Mailing Address - State:IA
Mailing Address - Zip Code:50142-0133
Mailing Address - Country:US
Mailing Address - Phone:641-351-2788
Mailing Address - Fax:
Practice Address - Street 1:821 5TH AVE STE 401
Practice Address - Street 2:
Practice Address - City:GRINNELL
Practice Address - State:IA
Practice Address - Zip Code:50112-1689
Practice Address - Country:US
Practice Address - Phone:641-323-2729
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-14
Last Update Date:2019-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1972907061Medicaid