| Restored Hope Counseling Services Llc | |
|
108 Main Ave Sw Ste 903 Warren OH 44481-1010 | |
| (330) 219-5892 | |
| (234) 600-5564 |
| Full Name | Restored Hope Counseling Services Llc |
|---|---|
| Speciality | Counselor |
| Location | 108 Main Ave Sw Ste 903, Warren, Ohio |
| Authorized Official Name and Position | Queenie V Lathan (CLINICAL COUNSELOR) |
| Authorized Official Contact | 3302195892 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Restored Hope Counseling Services Llc 108 Main Avenue, Sw Suite 903 Warren OH 44481 Ph: (330) 219-5892 | Restored Hope Counseling Services Llc 108 Main Ave Sw Ste 903 Warren OH 44481-1010 Ph: (330) 219-5892 |
| NPI Number | 1811417587 |
|---|---|
| Provider Enumeration Date | 06/23/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 6103215330 |
|---|---|
| Medicare Enrollment ID | O20211110000202 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811417587 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | E0700418SUPV (Ohio) | Primary |
| Provider Name | Loretta Prince |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992782825 PECOS PAC ID: 3072517143 Enrollment ID: I20060831000522 |
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