=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053859769
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JAMII COUNSELING & CONSULTING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/02/2017
-----------------------------------------------------
Last Update Date | 06/29/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 535 ROUTE 38 STE 128D
-----------------------------------------------------
City | CHERRY HILL
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08002-2953
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 856-441-5279
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 151 OLIVE ST
-----------------------------------------------------
City | CHERRY HILL
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08002-3401
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-845-8427
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF SERVICES
-----------------------------------------------------
Name | MS. LORRAINE Y. HOWARD
-----------------------------------------------------
Credential | LCSW, LCADC
-----------------------------------------------------
Telephone | 609-845-8427
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 44SC05490200
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------