Hope Reborn Counseling, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801090473 Issued in MI

Legal business name

HOPE REBORN COUNSELING, PLLC

Practice address

2816 Willa Dr
Saint Joseph, MI 49085

Phone

(269) 359-1065

Fax

(269) 985-0247

NPI assigned

Jan 4, 2018

Organization subpart

No

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

Authorized official

Name

Ms. Nadine Renee Fish, LMSW, CAADCNPI 1790097640

Title

Owner

Phone

(269) 359-1065

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nadine Renee Fish, MSW

  • Social Worker
  • Benton Harbor, MI
  • NPI 1790097640
  NPD Authorized official

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

{
    "created_epoch": "1515024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528156800000",
    "number": "1356858997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2816 WILLA DR",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852555",
            "telephone_number": "269-359-1065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2816 WILLA DR",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "49085",
            "telephone_number": "269-359-1065",
            "fax_number": "269-985-0247"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 W Centre Ave Lowr 105",
            "address_purpose": "LOCATION",
            "city": "Portage",
            "state": "MI",
            "postal_code": "490246307",
            "country_code": "US",
            "telephone_number": "269-359-1065",
            "fax_number": "269-985-0247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HOPE REBORN COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-04",
        "last_updated": "2018-06-05",
        "status": "A",
        "authorized_official_last_name": "FISH",
        "authorized_official_first_name": "NADINE",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "269-359-1065",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMSW, CAADC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801090473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Shannon Hoven

• Clinical Social Worker in Saint Joseph, MI
• Providers in Saint Joseph, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.