Provider Demographics
NPI:1053996751
Name:HOPESIDE COUNSELING, LLC
Entity type:Organization
Organization Name:HOPESIDE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HOPE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIDELEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-302-9854
Mailing Address - Street 1:PO BOX 652
Mailing Address - Street 2:
Mailing Address - City:WAREHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02571-0652
Mailing Address - Country:US
Mailing Address - Phone:617-302-9854
Mailing Address - Fax:
Practice Address - Street 1:242 WAREHAM RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:MA
Practice Address - Zip Code:02738-1163
Practice Address - Country:US
Practice Address - Phone:617-302-9854
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-14
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health