Provider Demographics
NPI:1902678089
Name:START WITH HOPE LLC
Entity Type:Organization
Organization Name:START WITH HOPE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL, CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:WITH HOPE
Authorized Official - Last Name:BERESH
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-S
Authorized Official - Phone:234-200-5780
Mailing Address - Street 1:PO BOX 2101
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-0101
Mailing Address - Country:US
Mailing Address - Phone:234-200-5780
Mailing Address - Fax:
Practice Address - Street 1:1206 N MAIN ST STE 123
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-1926
Practice Address - Country:US
Practice Address - Phone:234-200-5780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0202744Medicaid
12385514OtherCAQH