Hope Revisited Counseling Services PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

HOPE REVISITED COUNSELING SERVICES PLLC

Doing business as

Hope Revisited Counseling Services

Practice address

500 W Robert Bush Dr Ste 3
South Bend, WA 98586-9075

Phone

(360) 209-3240

NPI assigned

Dec 24, 2020

Last updated

Dec 24, 2020By 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

Mrs. Gina Renee Miles, LICSWNPI 1124651419

Title

Owner

Phone

(509) 821-1035

Specialties & licenses 1

Addresses

Other names 1

• Hope Revisited Counseling Services Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

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.

• Gina Renee Miles, LICSW

  • Clinical Social Worker
  • Montesano, WA
  • NPI 1124651419
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1608768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608768000000",
    "number": "1740877638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 532",
            "city": "SOUTH BEND",
            "state": "WA",
            "postal_code": "985860532",
            "telephone_number": "509-821-1035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W ROBERT BUSH DR STE 3",
            "city": "SOUTH BEND",
            "state": "WA",
            "postal_code": "985869075",
            "telephone_number": "360-209-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOPE REVISITED COUNSELING SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-24",
        "last_updated": "2020-12-24",
        "certification_date": "2020-12-24",
        "status": "A",
        "authorized_official_last_name": "MILES",
        "authorized_official_first_name": "GINA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-821-1035",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hope Revisited Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jack Hamson, M.D.
• Harbor Family Practice Inc
• Dawn Allison Hebert, RN
• Steven Frederick Hill, D.O.
• Frank A Hing, MD
• Amber Lee Jacobs, ARNP
• Sambasivarao Venkata Karanam, MD
• Trudi K Kulp, PT
• Myograsp Bodywork
• Amir Sean Nagavi, MD

• Clinical Social Worker in South Bend, WA
• Providers in South Bend, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2020; 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.