NPI Code Detail JSON Logo

1558880260 NPI number — JACOB JOSEPH AND JABEZ FAMILY COUNSELING AND PROFESSIONAL SERVICES GRO

NPI Number: 1558880260
Health Care Provider/Practitioner: JACOB JOSEPH AND JABEZ FAMILY COUNSELING AND PROFESSIONAL SERVICES GRO

Information about “1558880260” NPI (JACOB JOSEPH AND JABEZ FAMILY COUNSELING AND PROFESSIONAL SERVICES GRO) exists in 1558880260 in HTML format HTML  |  1558880260 in plain Text format TXT  |  1558880260 in PDF (Portable Document Format) PDF  |  1558880260 in an XML format XML  formats.

NPI Number : 1558880260 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1558880260",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "JACOB JOSEPH AND JABEZ FAMILY COUNSELING AND PROFESSIONAL SERVICES GRO",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2655 VILLA CREEK DR STE 201",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FARMERS BRANCH",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "75234-7324",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "972-803-6950",
    "MailingAddressFaxNumber": "951-823-5507",
    "FirstLinePracticeLocationAddress": "325 W HOSPITALITY LN STE 110",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SAN BERNARDINO",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92408-3210",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "909-332-7707",
    "PracticeLocationAddressFaxNumber": "951-823-5507",
    "EnumerationDate": "09/13/2017",
    "LastUpdateDate": "06/08/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "JONES",
    "AuthorizedOfficialFirstName": "LA CENA",
    "AuthorizedOfficialMiddleName": "LACHELLE",
    "AuthorizedOfficialTitle": "CEO/ MARRIAGE FAMILY THERAPIST",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "LMFT",
    "AuthorizedOfficialTelephoneNumber": "310-213-0944",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "106H00000X",
          "TaxonomyName": "Marriage & Family Therapist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QM0850X",
          "TaxonomyName": "Adult Mental Health Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QM0855X",
          "TaxonomyName": "Adolescent and Children Mental Health Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "251S00000X",
          "TaxonomyName": "Community/Behavioral Health Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        }
      ]
    }
  }
}
                
            

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