Inspired Hope | |
70 Park St Ste 101 Montclair NJ 07042-2960 | |
(973) 902-3775 | |
(973) 447-3999 |
Full Name | Inspired Hope |
---|---|
Speciality | Counselor |
Location | 70 Park St Ste 101, Montclair, New Jersey |
Authorized Official Name and Position | Dori Legrand-christmas (LICENSED CLINICAL SOCIAL WORKER) |
Authorized Official Contact | 9739023775 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Inspired Hope 70 Park St Ste 101 Montclair NJ 07042-2960 Ph: (973) 902-3775 | Inspired Hope 70 Park St Ste 101 Montclair NJ 07042-2960 Ph: (973) 902-3775 |
NPI Number | 1649864927 |
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Provider Enumeration Date | 02/26/2021 |
Last Update Date | 11/02/2024 |
Certification Date | 11/02/2024 |
Medicare PECOS PAC ID | 2860874849 |
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Medicare Enrollment ID | O20220808002162 |
Identifier | Type | State | Issuer |
---|---|---|---|
1649864927 | NPI | - | NPPES |
0861545 | Medicaid | NJ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
Provider Name | Dori Legrand-christmas |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1992300289 PECOS PAC ID: 2466834361 Enrollment ID: I20220809000243 |
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