Provider Demographics
NPI:1598240723
Name:JLM MARRIAGE AND FAMILY THERAPY INC.
Entity Type:Organization
Organization Name:JLM MARRIAGE AND FAMILY THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIER
Authorized Official - Middle Name:
Authorized Official - Last Name:MANDERSCHEID
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:858-337-7830
Mailing Address - Street 1:1991 VILLAGE PARK WAY STE 100
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-1966
Mailing Address - Country:US
Mailing Address - Phone:858-633-6760
Mailing Address - Fax:
Practice Address - Street 1:1991 VILLAGE PARK WAY STE 100
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1966
Practice Address - Country:US
Practice Address - Phone:858-633-6760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-03
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty