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General NPI Number Information
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NPI Number | 1972022903
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Entity Type | Organization
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Legal Business Name | JENWEL COUNSELING LLC
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Dates
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Enumeration Date | 09/11/2017
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Last Update Date | 07/25/2024
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Provider Practice Location Address
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Address Line | 260 SW MADISON AVE STE 119-1
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City | CORVALLIS
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State | OR
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Zip | 97333-4798
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Country | US
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Telephone | 406-581-5830
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1441
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City | PHILOMATH
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State | OR
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Zip | 97370-1441
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Country | US
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Telephone | 406-581-5830
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER R WELTON
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Credential | LCSW
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Telephone | 406-581-5830
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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 | BBH-LCSW-19038
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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