Provider Demographics
NPI: | 1700246121 |
---|---|
Name: | PROJECT HOPE COUNSELING |
Entity Type: | Organization |
Organization Name: | PROJECT HOPE COUNSELING |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | EXECUTIVE DIRECTOR / OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ROBIN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | WINTER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LPC |
Authorized Official - Phone: | 845-222-6444 |
Mailing Address - Street 1: | 32 HARMONY RD |
Mailing Address - Street 2: | |
Mailing Address - City: | BREWSTER |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 10509-3019 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 300 FEDERAL RD STE 209 |
Practice Address - Street 2: | |
Practice Address - City: | BROOKFIELD |
Practice Address - State: | CT |
Practice Address - Zip Code: | 06804-2412 |
Practice Address - Country: | US |
Practice Address - Phone: | 845-222-6444 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2016-02-26 |
Last Update Date: | 2016-05-13 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CT | 002057 | 101YP2500X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Single Specialty |