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General NPI Number Information
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NPI Number | 1619171055
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Entity Type | Organization
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Legal Business Name | JL COUNSELING
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Dates
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Enumeration Date | 06/11/2007
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Last Update Date | 07/21/2008
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Provider Practice Location Address
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Address Line | 5516 OVERLOOK DR NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-1881
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Country | US
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Telephone | 505-235-4756
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Fax | 505-831-2591
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Provider Business Mailing Address
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Address Line | 5516 OVERLOOK DR NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-1881
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Country | US
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Telephone | 505-235-4756
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Fax | 505-831-2591
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Authorized Official
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Title or Position | OWNER
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Name | MS. JOAN LYNNE LEVINE
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Credential | LISW
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Telephone | 505-831-2591
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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 | I06070
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License Number State | NM
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