MEDICARE: JARAN COUNSELING 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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1922694785
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JARAN COUNSELING LLC

Provider Business Mailing Address
First Line	:	1448 SAINT LOUIS ST
Second Line	:
City	:	FLORISSANT
State	:	MO
Zip	:	63033-3444
Country	:	US
Telephone Number	:	314-374-6278
Fax Number	:	314-667-3398

Provider Business Practice Location Address
First Line	:	1448 SAINT LOUIS ST
Second Line	:
City	:	FLORISSANT
State	:	MO
Zip	:	63033-3444
Country	:	US
Telephone Number	:	314-667-3398
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ANGELA ELEANOR GRACE
Credential	:	MSW, LCSW
Telephone Number	:	314-374-6278

Provider Enumeration Date	:	12/16/2020
Last Update Date	:	10/26/2022

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Directions to “JARAN COUNSELING LLC ” Practice Location

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