Provider Demographics
NPI:1962007617
Name:BEACON OF HOPE, LLC
Entity Type:Organization
Organization Name:BEACON OF HOPE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:ROSEMARY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BARTLE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:307-267-0535
Mailing Address - Street 1:2424 E 9TH ST
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82609-2838
Mailing Address - Country:US
Mailing Address - Phone:307-267-0535
Mailing Address - Fax:
Practice Address - Street 1:1508 S CEDAR ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-4141
Practice Address - Country:US
Practice Address - Phone:307-267-0535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty