Provider Demographics
NPI:1356930416
Name:PROMISE OF HOPE COUNSELING INC
Entity type:Organization
Organization Name:PROMISE OF HOPE COUNSELING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:LEANNE
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:407-786-1913
Mailing Address - Street 1:2989 W STATE ROAD 434 STE 100
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-4898
Mailing Address - Country:US
Mailing Address - Phone:407-786-1913
Mailing Address - Fax:407-960-2636
Practice Address - Street 1:2989 W STATE ROAD 434 STE 100
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779-4898
Practice Address - Country:US
Practice Address - Phone:407-786-1913
Practice Address - Fax:407-960-2636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health