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General NPI Number Information
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NPI Number | 1629436530
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Entity Type | Organization
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Legal Business Name | JMB COUNSELING, PLLC
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Dates
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Enumeration Date | 02/05/2016
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Last Update Date | 02/05/2016
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Provider Practice Location Address
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Address Line | 2002 SHEA CV
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City | CEDAR PARK
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State | TX
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Zip | 78613-4124
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Country | US
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Telephone | 512-797-7636
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Fax |
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Provider Business Mailing Address
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Address Line | 2002 SHEA CV
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City | CEDAR PARK
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State | TX
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Zip | 78613-4124
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNY BAUERLEIN
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Credential | LCSW
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Telephone | 512-797-7636
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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 | 39080
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License Number State | TX
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