Provider Demographics
NPI:1255043410
Name:HOPE AND HEALING BEHAVIORAL HEALTH PLLC
Entity type:Organization
Organization Name:HOPE AND HEALING BEHAVIORAL HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:ZERFOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:217-207-0041
Mailing Address - Street 1:1135 ROSEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT ZION
Mailing Address - State:IL
Mailing Address - Zip Code:62549-1046
Mailing Address - Country:US
Mailing Address - Phone:217-207-0041
Mailing Address - Fax:217-207-0042
Practice Address - Street 1:5130 HICKORY POINT FRONTAGE RD STE 230
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62526-9773
Practice Address - Country:US
Practice Address - Phone:217-207-0041
Practice Address - Fax:217-207-0042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty