NPIMap

Organization Active NPI

Harbor of Hope Medical and Behavioral Health Care, LLC

  • Professional Counselor
  • Barbourville, KY
National Provider Identifier
1134738412
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
HARBOR OF HOPE MEDICAL AND BEHAVIORAL HEALTH CARE, LLC
Practice address
185 Treuhaft Blvd
Ste 4
Barbourville, KY 40906-8300
Phone
(606) 545-6766
Fax
(606) 545-0366
NPI assigned
Jul 23, 2020
Last updated
Jan 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Thelma Jean Gray, APRNNPI 1548755499
Title
Aprn/Owner
Phone
(606) 545-6766

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU Primary

Addresses

Primary practice location

185 Treuhaft Blvd
Ste 4
Barbourville, KY 40906-8300

Mailing address

868 Sam Parker Rd
Gray, KY 40734-6780
Phone (606) 269-3428

Other identifiers 1

IdentifierTypeStateIssuer
7100663490MedicaidKY

National Provider Directory

National Provider Directory
Tax ID family
Harbor of Hope Medical and Behavioral Health Care LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675036800000",
    "number": "1134738412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "868 SAM PARKER RD",
            "city": "GRAY",
            "state": "KY",
            "postal_code": "407346780",
            "telephone_number": "606-269-3428",
            "fax_number": "606-545-0366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 TREUHAFT BLVD",
            "address_2": "STE 4",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "409068300",
            "telephone_number": "606-545-6766",
            "fax_number": "606-545-0366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR OF HOPE MEDICAL AND BEHAVIORAL HEALTH CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-23",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-23",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "THELMA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "APRN/OWNER",
        "authorized_official_telephone_number": "606-545-6766",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100663490",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Barbourville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.