Provider Demographics
NPI:1396204236
Name:JKM COUNSELING LLC
Entity Type:Organization
Organization Name:JKM COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:SHANNA KLEIN
Authorized Official - Last Name:MONTARULI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:646-373-0727
Mailing Address - Street 1:119 E HARTSDALE AVE APT 6B
Mailing Address - Street 2:
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-3213
Mailing Address - Country:US
Mailing Address - Phone:646-373-0727
Mailing Address - Fax:
Practice Address - Street 1:280 DOBBS FERRY RD STE 200
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10607-1908
Practice Address - Country:US
Practice Address - Phone:914-338-8706
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-19
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty