Provider Demographics
NPI:1679951198
Name:JFRCOUNSELING, LLC
Entity type:Organization
Organization Name:JFRCOUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CLINICAL PSYCHOTHERAPIST
Authorized Official - Prefix:PROF
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MED, RMHCI, CAP
Authorized Official - Phone:954-257-3480
Mailing Address - Street 1:1080 SE 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-1108
Mailing Address - Country:US
Mailing Address - Phone:954-257-3480
Mailing Address - Fax:
Practice Address - Street 1:1080 SE 3RD AVE
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-1108
Practice Address - Country:US
Practice Address - Phone:954-257-3480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-16
Last Update Date:2015-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL11000117623261QR0401X, 261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)