Provider Demographics
NPI:1891098125
Name:HOPE COUNSELING AND MEDIATION CENTER LLC
Entity Type:Organization
Organization Name:HOPE COUNSELING AND MEDIATION CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:M
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:401-721-5228
Mailing Address - Street 1:1525 OLD LOUISQUISSET PIKE
Mailing Address - Street 2:SUITE C-103
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-4503
Mailing Address - Country:US
Mailing Address - Phone:401-721-5228
Mailing Address - Fax:
Practice Address - Street 1:1525 OLD LOUISQUISSET PIKE
Practice Address - Street 2:SUITE C-103
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-4503
Practice Address - Country:US
Practice Address - Phone:401-721-5228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-08
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILMF00096106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty