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NPI Code Detail

MEDICARE: CJ FAMILY & CONSULTING SERVICES, LLC

MEDICARE: CJ FAMILY & CONSULTING SERVICES, 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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1164020814
Entity Type Code : Organization
Provider Name (Legal Business Name) : CJ FAMILY & CONSULTING SERVICES, LLC
Provider Business Mailing Address
First Line : HARBOR POINTE PKWY
Second Line :
City : SANDY SPRINGS
State : GA
Zip : 30350-5838
Country : US
Telephone Number : 678-433-6808
Fax Number :
Provider Business Practice Location Address
First Line : HARBOR POINTE PKWY
Second Line :
City : SANDY SPRINGS
State : GA
Zip : 30350-5838
Country : US
Telephone Number : 678-433-6808
Fax Number :
Authorized Official
Title or Position : MENTAL HEALTH THERAPIST
Name : JESAIRA GLOVER
Credential : LAPC
Telephone Number : 470-309-2703
Provider Enumeration Date : 10/14/2020
Last Update Date : 11/20/2020

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Directions to “CJ FAMILY & CONSULTING SERVICES, LLC ” Practice Location

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