Provider Demographics
NPI:1922590462
Name:ANCHORED HOPE, LLC
Entity Type:Organization
Organization Name:ANCHORED HOPE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:T.AIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMPLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:618-967-0363
Mailing Address - Street 1:706 S JESSE ST
Mailing Address - Street 2:
Mailing Address - City:CHRISTOPHER
Mailing Address - State:IL
Mailing Address - Zip Code:62822-1438
Mailing Address - Country:US
Mailing Address - Phone:618-967-0363
Mailing Address - Fax:
Practice Address - Street 1:6 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:DU QUOIN
Practice Address - State:IL
Practice Address - Zip Code:62832-1312
Practice Address - Country:US
Practice Address - Phone:618-967-0363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-31
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.018640101YM0800X
IL149020041101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty