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General NPI Number Information
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NPI Number | 1396204236
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Entity Type | Organization
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Legal Business Name | JKM COUNSELING LLC
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Dates
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Enumeration Date | 03/19/2019
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Last Update Date | 03/19/2019
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Provider Practice Location Address
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Address Line | 280 DOBBS FERRY RD STE 200
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City | WHITE PLAINS
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State | NY
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Zip | 10607-1908
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Country | US
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Telephone | 914-338-8706
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Fax |
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Provider Business Mailing Address
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Address Line | 119 E HARTSDALE AVE APT 6B
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City | HARTSDALE
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State | NY
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Zip | 10530-3213
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Country | US
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Telephone | 646-373-0727
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JULIE SHANNA KLEIN MONTARULI
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Credential | LCSW
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Telephone | 646-373-0727
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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 |
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License Number State |
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