Provider Demographics
NPI:1073139770
Name:KJS COUNSELING AND CONSULTING LLC
Entity Type:Organization
Organization Name:KJS COUNSELING AND CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:508-847-1907
Mailing Address - Street 1:41 TASSELS LOOP
Mailing Address - Street 2:
Mailing Address - City:BRECKENRIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80424-8814
Mailing Address - Country:US
Mailing Address - Phone:508-847-1907
Mailing Address - Fax:
Practice Address - Street 1:41 TASSELS LOOP
Practice Address - Street 2:
Practice Address - City:BRECKENRIDGE
Practice Address - State:CO
Practice Address - Zip Code:80424-8814
Practice Address - Country:US
Practice Address - Phone:508-847-1907
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-18
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health