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General NPI Number Information
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NPI Number | 1629918412
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Entity Type | Organization
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Legal Business Name | JLK THERAPY
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Dates
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Enumeration Date | 03/31/2026
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Last Update Date | 03/31/2026
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Provider Practice Location Address
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Address Line | 220 W WASHINGTON ST STE 405
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City | MARQUETTE
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State | MI
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Zip | 49855-4347
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Country | US
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Telephone | 906-251-1661
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Fax |
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Provider Business Mailing Address
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Address Line | 220 W WASHINGTON ST STE 405
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City | MARQUETTE
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State | MI
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Zip | 49855-4347
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Country | US
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Telephone | 906-251-1661
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JULIE LAINE KOSTICH-CONNORS
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Credential | LPC
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Telephone | 906-251-1661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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