MEDICARE: JL COUNSELING SERVICES LCSW P.C.

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1245745751
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JL COUNSELING SERVICES LCSW P.C.

Provider Business Mailing Address
First Line	:	8 W 126TH ST FL 3
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10027-3811
Country	:	US
Telephone Number	:	646-316-4090
Fax Number	:

Provider Business Practice Location Address
First Line	:	8 W 126TH ST FL 3
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10027-3811
Country	:	US
Telephone Number	:	646-316-4090
Fax Number	:

Authorized Official
Title or Position	:	ADMIN DIRECTOR
Name	:	MR. ALEX B LAKOJU
Credential	:
Telephone Number	:	646-316-4090

Provider Enumeration Date	:	12/06/2017
Last Update Date	:	12/06/2017

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