Provider Demographics
NPI:1477259117
Name:MHJM COUNSELING LLC
Entity Type:Organization
Organization Name:MHJM COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIRAN
Authorized Official - Middle Name:H
Authorized Official - Last Name:MCCLENDON
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC, LCADC
Authorized Official - Phone:502-819-3138
Mailing Address - Street 1:12468 LA GRANGE RD # 322
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40245-1901
Mailing Address - Country:US
Mailing Address - Phone:502-819-3138
Mailing Address - Fax:
Practice Address - Street 1:4122 WAHL STREET BLVD STE 15
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-3265
Practice Address - Country:US
Practice Address - Phone:502-530-0440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-03
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty