Tricord Hope LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC005921 Issued in GA

Legal business name

TRICORD HOPE LLC

Practice address

141 Highway 142
Covington, GA 30014-4857

Phone

(770) 658-9012

NPI assigned

Feb 19, 2018

Last updated

Jun 16, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tim I Bolen, LPC

Title

Director

Phone

(770) 658-9012

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Timothy Irvin Bolen, LPC

  • Professional Counselor
  • Covington, GA
  • NPI 1649770025
  NPD (past)

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

{
    "created_epoch": "1518998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1245730001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 MOUNT ZION RD",
            "city": "OXFORD",
            "state": "GA",
            "postal_code": "300542626",
            "telephone_number": "770-658-9012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 HIGHWAY 142",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300144857",
            "telephone_number": "770-658-9012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRICORD HOPE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-19",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "BOLEN",
        "authorized_official_first_name": "TIM",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "770-658-9012",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC005921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Covington, GA
• Providers in Covington, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.