Provider Demographics
NPI:1053066720
Name:JJLPCOUNSELOR PLLC
Entity type:Organization
Organization Name:JJLPCOUNSELOR PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:JULIANA
Authorized Official - Suffix:
Authorized Official - Credentials:MA, NCC
Authorized Official - Phone:970-946-3709
Mailing Address - Street 1:2508 DELWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-4543
Mailing Address - Country:US
Mailing Address - Phone:970-946-3709
Mailing Address - Fax:
Practice Address - Street 1:2508 DELWOOD AVE
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-4543
Practice Address - Country:US
Practice Address - Phone:970-946-3709
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-21
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty