Provider Demographics
NPI:1629567409
Name:HOPE PSYCHOLOGICAL CARE
Entity type:Organization
Organization Name:HOPE PSYCHOLOGICAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:VANSICKLE-DEAVOURS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-393-9663
Mailing Address - Street 1:2615 PRAIRIE ELM DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66047-4211
Mailing Address - Country:US
Mailing Address - Phone:785-393-9663
Mailing Address - Fax:
Practice Address - Street 1:1201 WAKARUSA DR STE E203
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-1892
Practice Address - Country:US
Practice Address - Phone:785-393-9663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-07
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS321101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty