Provider Demographics
NPI:1164020814
Name:CJ FAMILY & CONSULTING SERVICES, LLC
Entity Type:Organization
Organization Name:CJ FAMILY & CONSULTING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JESAIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:GLOVER
Authorized Official - Suffix:
Authorized Official - Credentials:LAPC
Authorized Official - Phone:470-309-2703
Mailing Address - Street 1:HARBOR POINTE PKWY
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30350-5838
Mailing Address - Country:US
Mailing Address - Phone:678-433-6808
Mailing Address - Fax:
Practice Address - Street 1:HARBOR POINTE PKWY
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30350-5838
Practice Address - Country:US
Practice Address - Phone:678-433-6808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-14
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty