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General NPI Number Information
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NPI Number | 1568096857
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Entity Type | Organization
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Legal Business Name | AJM CLINICAL THERAPY & CONSULTING, PLLC
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Dates
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Enumeration Date | 02/26/2020
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Last Update Date | 03/07/2022
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Provider Practice Location Address
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Address Line | 1666 N HAMPTON RD STE 103
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City | DESOTO
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State | TX
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Zip | 75115-2390
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Country | US
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Telephone | 817-677-8382
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Fax |
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Provider Business Mailing Address
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Address Line | 2750 CLEAR LAKE DR
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City | MIDLOTHIAN
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State | TX
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Zip | 76065-6251
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Country | US
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Telephone | 469-765-2014
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | ASHLEY JONES-MCCRACKEN
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Credential | LCSW
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Telephone | 817-677-8382
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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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