Provider Demographics
NPI:1356904932
Name:AN INSPIRED HOPE COUNSELING PLLC
Entity type:Organization
Organization Name:AN INSPIRED HOPE COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:
Authorized Official - Last Name:GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:469-930-6360
Mailing Address - Street 1:1510 N HAMPTON RD STE 220
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-8301
Mailing Address - Country:US
Mailing Address - Phone:469-930-6360
Mailing Address - Fax:469-930-6362
Practice Address - Street 1:1510 N HAMPTON RD STE 220
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-8301
Practice Address - Country:US
Practice Address - Phone:469-930-6360
Practice Address - Fax:469-930-6362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-18
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX310713801Medicaid
TX307002103Medicaid