Provider Demographics
NPI:1013956101
Name:INTERHOPE COUNSELING SERVICES, INC
Entity type:Organization
Organization Name:INTERHOPE COUNSELING SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:L
Authorized Official - Last Name:VANHORN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:606-928-0150
Mailing Address - Street 1:PO BOX 5191
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-5191
Mailing Address - Country:US
Mailing Address - Phone:606-928-0150
Mailing Address - Fax:606-929-5965
Practice Address - Street 1:10730 MIDLAND TRAIL DR.
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41102-5191
Practice Address - Country:US
Practice Address - Phone:606-928-0150
Practice Address - Fax:606-929-5965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-05
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-10721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY00096Medicare PIN