MEDICARE: JCL RESOURCES AND SOLUTIONS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1073104436
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JCL RESOURCES AND SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	1622 WILLOW CREEK DR
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48917-7817
Country	:	US
Telephone Number	:	260-676-7519
Fax Number	:

Provider Business Practice Location Address
First Line	:	1622 WILLOW CREEK DR
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48917-7817
Country	:	US
Telephone Number	:	260-676-7519
Fax Number	:

Authorized Official
Title or Position	:	CLINICIAN/OWNER
Name	:	JODI LYNN CAROLAND
Credential	:	MA LPC NCC
Telephone Number	:	260-676-7519

Provider Enumeration Date	:	01/28/2021
Last Update Date	:	01/28/2021

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