Basic Information
| Provider Information | |||||||||
| NPI: | 1801050232 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HELLER | ||||||||
| FirstName: | HOPE | ||||||||
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| Credential: | LPC, NCC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8906 W 97TH ST | ||||||||
| Address2: | |||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662124014 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9139526696 | ||||||||
| FaxNumber: | 9133813307 | ||||||||
| Practice Location | |||||||||
| Address1: | 8906 W 97TH ST | ||||||||
| Address2: | |||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662124014 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9139526696 | ||||||||
| FaxNumber: | 9133813307 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/15/2008 | ||||||||
| LastUpdateDate: | 02/11/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 2007025933 | MO | N | Behavioral Health & Social Service Providers | Counselor | Professional | 101YP2500X | 1884 | KS | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
ID Information
| ID | Type | State | Issuer | Description | 1801050232 | 05 | MO | MEDICAID |