Healthcare Provider Details

I. General information

NPI: 1073104436
Provider Name (Legal Business Name): JCL RESOURCES AND SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2021
Last Update Date: 01/28/2021
Certification Date: 01/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1622 WILLOW CREEK DR
LANSING MI
48917-7817
US

IV. Provider business mailing address

1622 WILLOW CREEK DR
LANSING MI
48917-7817
US

V. Phone/Fax

Practice location:
  • Phone: 260-676-7519
  • Fax:
Mailing address:
  • Phone: 260-676-7519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: JODI LYNN CAROLAND
Title or Position: CLINICIAN/OWNER
Credential: MA LPC NCC
Phone: 260-676-7519