Promise of Hope Counseling Inc

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

PROMISE OF HOPE COUNSELING INC

Practice address

2989 W State Road 434 Ste 100
Longwood, FL 32779-4898

Phone

(407) 786-1913

Fax

(407) 960-2636

NPI assigned

Jan 13, 2021

Last updated

Jan 13, 2021By 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

Dana Leanne Shaw, BS

Title

President

Phone

(407) 786-1913

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

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.

• Kaitlin Bowen, MA, LMHC

  • Mental Health Counselor
  • Longwood, FL
  • NPI 1639829021
  Medicare reassignment NPD

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

{
    "created_epoch": "1610496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610496000000",
    "number": "1356930416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2989 W STATE ROAD 434 STE 100",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327794898",
            "telephone_number": "407-786-1913",
            "fax_number": "407-960-2636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2989 W STATE ROAD 434 STE 100",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327794898",
            "telephone_number": "407-786-1913",
            "fax_number": "407-960-2636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMISE OF HOPE COUNSELING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-13",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "LEANNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-786-1913",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Mental Health Clinic/Center in Longwood, FL
• Providers in Longwood, FL by specialty
• Adult Mental Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.