Provider Demographics
NPI:1225894991
Name:MJL PROFESSIONAL SERVICES, INC.
Entity Type:Organization
Organization Name:MJL PROFESSIONAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KINTZING
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:303-875-6207
Mailing Address - Street 1:PO BOX 20944
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80308
Mailing Address - Country:US
Mailing Address - Phone:720-602-7972
Mailing Address - Fax:303-530-1338
Practice Address - Street 1:8471 TURNPIKE DR STE 205
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-7050
Practice Address - Country:US
Practice Address - Phone:303-875-6207
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-21
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty