Provider Demographics
NPI:1275305245
Name:JTD COUNSELING AND CONSULTING, LLC
Entity Type:Organization
Organization Name:JTD COUNSELING AND CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:417-880-1454
Mailing Address - Street 1:414 SOUTH AVE APT A
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65806-2138
Mailing Address - Country:US
Mailing Address - Phone:417-880-1454
Mailing Address - Fax:
Practice Address - Street 1:414 SOUTH AVE APT A
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65806-2138
Practice Address - Country:US
Practice Address - Phone:417-880-1454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty