MEDICARE: JOBIN AND ASSOCIATES 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	101YA0400X	Addiction (Substance Use Disorder) Counselor	00417-LC	NV
2	101YM0800X	Mental Health Counselor	CP0174	NV

General Provider Information

NPI Number	:	1477035970
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOBIN AND ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	7004 GERONIMO SPRINGS AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89179-1203
Country	:	US
Telephone Number	:	702-215-9762
Fax Number	:

Provider Business Practice Location Address
First Line	:	7004 GERONIMO SPRINGS AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89179-1203
Country	:	US
Telephone Number	:	702-215-9762
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JAMES MICHAEL JOBIN II
Credential	:	LCPC, LCADC
Telephone Number	:	702-215-9762

Provider Enumeration Date	:	08/30/2018
Last Update Date	:	08/30/2018

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