Healthcare Provider Details

I. General information

NPI: 1851201966
Provider Name (Legal Business Name): JK COUNSELING COLLABORATIVE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S 1ST ST SUITE 522
ANN ARBOR MI
48104-1306
US

IV. Provider business mailing address

200 S 1ST ST
ANN ARBOR MI
48104-1306
US

V. Phone/Fax

Practice location:
  • Phone: 734-635-8686
  • Fax:
Mailing address:
  • Phone: 734-635-8686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: JOSEANNA KIMBALL
Title or Position: MANAGING MEMBER
Credential: LPC
Phone: 734-635-8686