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General NPI Number Information
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NPI Number | 1760986343
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Entity Type | Organization
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Legal Business Name | PERSONAL COUNSELING & WELLNESS, LLC
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Dates
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Enumeration Date | 03/20/2018
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Last Update Date | 07/12/2018
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Provider Practice Location Address
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Address Line | 9999 GRANGER RD STE 2
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City | GARFIELD HEIGHTS
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State | OH
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Zip | 44125
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Country | US
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Telephone | 440-862-0871
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Fax |
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Provider Business Mailing Address
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Address Line | 9999 GRANGER RD STE 2
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City | GARFIELD HEIGHTS
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State | OH
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Zip | 44125-5319
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Country | US
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Telephone | 440-862-0871
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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. JACQUELINE M. JAROS
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Credential | LISW, LCSW
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Telephone | 440-862-0871
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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 | I.0800237
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License Number State | OH
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