Healthcare Provider Details

I. General information

NPI: 1801547435
Provider Name (Legal Business Name): J&M ADVISORS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2022
Last Update Date: 01/14/2022
Certification Date: 01/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4304 SIR JULIAN CT
RALEIGH NC
27610-8717
US

IV. Provider business mailing address

PO BOX 46751
RALEIGH NC
27620-6751
US

V. Phone/Fax

Practice location:
  • Phone: 984-920-2866
  • Fax:
Mailing address:
  • Phone: 347-927-6107
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MCKENZIE COURTNEY JOHNSON
Title or Position: MEMBER
Credential: LCMHC
Phone: 984-920-2866