Provider Demographics
NPI:1437751476
Name:JSUG CREATIONS
Entity Type:Organization
Organization Name:JSUG CREATIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:SUGERMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:ACC
Authorized Official - Phone:571-426-0413
Mailing Address - Street 1:301 LAS COLINAS BLVD W APT 300
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-5481
Mailing Address - Country:US
Mailing Address - Phone:571-426-0413
Mailing Address - Fax:
Practice Address - Street 1:301 LAS COLINAS BLVD W APT 300
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-5481
Practice Address - Country:US
Practice Address - Phone:571-426-0413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
No405300000XOther Service ProvidersPrevention ProfessionalGroup - Multi-Specialty