MEDICARE: JSUG CREATIONS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	171W00000X	Contractor
3	405300000X	Prevention Professional
4	101Y00000X	Counselor

General Provider Information

NPI Number	:	1437751476
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JSUG CREATIONS

Provider Business Mailing Address
First Line	:	301 LAS COLINAS BLVD W APT 300
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75039-5481
Country	:	US
Telephone Number	:	571-426-0413
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 LAS COLINAS BLVD W APT 300
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75039-5481
Country	:	US
Telephone Number	:	571-426-0413
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER
Name	:	JENNIFER SUGERMEYER
Credential	:	ACC
Telephone Number	:	571-426-0413

Provider Enumeration Date	:	11/13/2020
Last Update Date	:	11/13/2020

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Directions to “JSUG CREATIONS ” Practice Location

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