Provider Demographics
NPI:1235514969
Name:HOPEWELL MENTAL HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:HOPEWELL MENTAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:L
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:614-580-2500
Mailing Address - Street 1:PO BOX 1186
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-1186
Mailing Address - Country:US
Mailing Address - Phone:614-796-0338
Mailing Address - Fax:614-890-5485
Practice Address - Street 1:7625 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-9649
Practice Address - Country:US
Practice Address - Phone:614-717-1800
Practice Address - Fax:614-717-1801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-23
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0138900Medicaid
OHH404550OtherMEDICARE