Provider Demographics
NPI:1558880260
Name:JACOB JOSEPH AND JABEZ FAMILY COUNSELING AND PROFESSIONAL SERVICES GRO
Entity Type:Organization
Organization Name:JACOB JOSEPH AND JABEZ FAMILY COUNSELING AND PROFESSIONAL SERVICES GRO
Other - Org Name:JACOB JOSEPH AND JABEZ FAMILY COUNSELING AND PROFESSIONAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/ MARRIAGE FAMILY THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LA CENA
Authorized Official - Middle Name:LACHELLE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:310-213-0944
Mailing Address - Street 1:2655 VILLA CREEK DR STE 201
Mailing Address - Street 2:
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7324
Mailing Address - Country:US
Mailing Address - Phone:972-803-6950
Mailing Address - Fax:951-823-5507
Practice Address - Street 1:325 W HOSPITALITY LN STE 110
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3210
Practice Address - Country:US
Practice Address - Phone:909-332-7707
Practice Address - Fax:951-823-5507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-13
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Single Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health