Provider Demographics
NPI:1962165381
Name:PEAKS OF HOPE COUNSELING, LLC
Entity type:Organization
Organization Name:PEAKS OF HOPE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:507-884-6164
Mailing Address - Street 1:822 BROADWAY AVE S
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55904-6443
Mailing Address - Country:US
Mailing Address - Phone:507-884-6164
Mailing Address - Fax:507-208-7626
Practice Address - Street 1:822 BROADWAY AVE S
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55904-6443
Practice Address - Country:US
Practice Address - Phone:507-884-6164
Practice Address - Fax:507-208-7626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty