=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548413032
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JFL & ASSOCIATES COUNSELING SERVICES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/28/2008
-----------------------------------------------------
Last Update Date | 11/09/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1050 CONNECTICUT AVE SUITE 500
-----------------------------------------------------
City | WASHINGTON
-----------------------------------------------------
State | DC
-----------------------------------------------------
Zip | 20036
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-686-7420
-----------------------------------------------------
Fax | 202-204-5881
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1050 CONNECTICUT AVE SUITE 500
-----------------------------------------------------
City | WASHINGTON
-----------------------------------------------------
State | DC
-----------------------------------------------------
Zip | 20036
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-686-7420
-----------------------------------------------------
Fax | 202-204-5881
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CLINIC DIRECTOR, CEO
-----------------------------------------------------
Name | JOANNE FREDERICK
-----------------------------------------------------
Credential | ED.D
-----------------------------------------------------
Telephone | 301-686-7420
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number | PRC13962
-----------------------------------------------------
License Number State | DC
-----------------------------------------------------