MEDICARE: J.B. FAMILY COUNSELING CENTER 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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1215742275
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J.B. FAMILY COUNSELING CENTER LLC

Provider Business Mailing Address
First Line	:	9321 WICKER AVE STE 205
Second Line	:
City	:	SAINT JOHN
State	:	IN
Zip	:	46373-2301
Country	:	US
Telephone Number	:	219-558-0232
Fax Number	:

Provider Business Practice Location Address
First Line	:	9321 WICKER AVE STE 205
Second Line	:
City	:	SAINT JOHN
State	:	IN
Zip	:	46373-2301
Country	:	US
Telephone Number	:	219-558-0232
Fax Number	:

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	JOSEPH MICHAEL AGUILERA
Credential	:
Telephone Number	:	219-558-0232

Provider Enumeration Date	:	02/07/2025
Last Update Date	:	02/18/2025

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