Healthcare Provider Details

I. General information

NPI: 1477395945
Provider Name (Legal Business Name): JMJ COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2024
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2033 E WARNER RD STE 111
TEMPE AZ
85284-3417
US

IV. Provider business mailing address

2033 E WARNER RD STE 111
TEMPE AZ
85284-3417
US

V. Phone/Fax

Practice location:
  • Phone: 480-818-6108
  • Fax:
Mailing address:
  • Phone: 480-818-6108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. JUAN MURILLO JR.
Title or Position: OWNER/COUNSELOR
Credential: LPC
Phone: 480-818-6108