Provider Demographics
NPI:1255014312
Name:ELEMENTS OF HOPE AND HEALING
Entity type:Organization
Organization Name:ELEMENTS OF HOPE AND HEALING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO / FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HANSON THIELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:541-270-0434
Mailing Address - Street 1:34392 GAROUTTE RD
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:OR
Mailing Address - Zip Code:97424-8538
Mailing Address - Country:US
Mailing Address - Phone:541-270-0434
Mailing Address - Fax:
Practice Address - Street 1:22 N 8TH ST
Practice Address - Street 2:
Practice Address - City:COTTAGE GROVE
Practice Address - State:OR
Practice Address - Zip Code:97424-2025
Practice Address - Country:US
Practice Address - Phone:541-270-0434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No252Y00000XAgenciesEarly Intervention Provider Agency
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)