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General NPI Number Information
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NPI Number | 1679425219
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Entity Type | Organization
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Legal Business Name | JRP COUNSELING LICENSED CLINICAL SOCIAL WORKER PROFESSIONAL
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Dates
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Enumeration Date | 02/13/2026
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Last Update Date | 02/13/2026
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Provider Practice Location Address
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Address Line | 1091 N PALM CANYON DR STE 11
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City | PALM SPRINGS
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State | CA
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Zip | 92262-4419
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Country | US
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Telephone | 951-305-3071
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Fax | 951-602-6006
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Provider Business Mailing Address
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Address Line | 1010 LYRA WAY
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City | BEAUMONT
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State | CA
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Zip | 92223-2079
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Country | US
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Telephone | 951-305-3071
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Fax | 951-602-6006
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Authorized Official
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Title or Position | PRESIDENT
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Name | JENNIFER NICOLE RUGALA PERSICONE
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Credential | LCSW
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Telephone | 951-255-1754
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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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