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General NPI Number Information
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NPI Number | 1205981065
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Entity Type | Organization
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Legal Business Name | JCR COUNSELING SERVICES, INC.
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 269 N UNIVERSITY DR SUITE G
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6715
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Country | US
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Telephone | 954-322-0538
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Fax | 954-322-9897
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Provider Business Mailing Address
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Address Line | PO BOX 246464
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-0124
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Country | US
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Telephone | 954-322-0538
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Fax | 954-322-9897
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Authorized Official
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Title or Position | OWNER, PRESIDENT
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Name | JUANITA SABRINA CONNER-RAINES
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Credential | LCSW
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Telephone | 954-322-0538
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW 4410
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License Number State | FL
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