Healthcare Provider Details

I. General information

NPI: 1790629806
Provider Name (Legal Business Name): EGJ COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1864 S KENTWOOD AVE
SPRINGFIELD MO
65804-2323
US

IV. Provider business mailing address

2957 S CAMBER AVE
SPRINGFIELD MO
65809-3547
US

V. Phone/Fax

Practice location:
  • Phone: 417-880-1724
  • Fax:
Mailing address:
  • Phone: 417-880-1724
  • Fax: 417-869-8401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. ERNEST GRANT JONES
Title or Position: PSYCHOLOGIST
Credential: PHD
Phone: 417-880-1724