Organization Name: | JMP COUNSELING AND TUTORING SERVICES, LLC |
NPI Number: | 1265618615 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GINA K. JOHNSON (LICENSED CLINICAL SOCIAL WORKER) |
Mailing Address: | 109 N. Main St. St. Joseph |
State: | IL US |
Postal Code: | 61873 |
Phone Number: | 2174699300 |
Fax Number: | 2174699301 |
NPI Enumeration Date: | 01/16/2008 |
NPI Last Update Date: | 03/06/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |