Provider Demographics
NPI:1568096857
Name:AJM CLINICAL THERAPY & CONSULTING, PLLC
Entity Type:Organization
Organization Name:AJM CLINICAL THERAPY & CONSULTING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES-MCCRACKEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:817-677-8382
Mailing Address - Street 1:2750 CLEAR LAKE DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-6251
Mailing Address - Country:US
Mailing Address - Phone:469-765-2014
Mailing Address - Fax:
Practice Address - Street 1:1666 N HAMPTON RD STE 103
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2390
Practice Address - Country:US
Practice Address - Phone:817-677-8382
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-26
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty