Provider Demographics
NPI:1871124644
Name:RESTORING HOPE COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:RESTORING HOPE COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDRENE
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNETT-WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:203-727-9675
Mailing Address - Street 1:218 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06604-2678
Mailing Address - Country:US
Mailing Address - Phone:203-727-9675
Mailing Address - Fax:
Practice Address - Street 1:218 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06604-2678
Practice Address - Country:US
Practice Address - Phone:203-727-9675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty