| Hope Again Counseling And Court Mediation, Llc | |
|
2005 Venture Park Kingsport TN 37660-1098 | |
| (423) 578-7878 | |
| (423) 578-6500 |
| Full Name | Hope Again Counseling And Court Mediation, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2005 Venture Park, Kingsport, Tennessee |
| Authorized Official Name and Position | Marsha G Rose (CHIEF EXECUTIVE OFFICER (CO-OWNER)) |
| Authorized Official Contact | 4235787878 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hope Again Counseling And Court Mediation, Llc 2005 Venture Park Kingsport TN 37660-1098 Ph: (423) 578-7878 | Hope Again Counseling And Court Mediation, Llc 2005 Venture Park Kingsport TN 37660-1098 Ph: (423) 578-7878 |
| NPI Number | 1619110319 |
|---|---|
| Provider Enumeration Date | 04/09/2009 |
| Last Update Date | 04/09/2009 |
| Medicare PECOS PAC ID | 3476605205 |
|---|---|
| Medicare Enrollment ID | O20090708000800 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619110319 | NPI | - | NPPES |
| 39275311 | Medicaid | TN | |
| 39246901 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LSW0000004305 (Tennessee) | Primary |
| Provider Name | Marsha G Rose |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689778672 PECOS PAC ID: 8729050059 Enrollment ID: I20040809000283 |
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