Provider Demographics
NPI:1609174051
Name:JSB CONSULTANT, LLC
Entity Type:Organization
Organization Name:JSB CONSULTANT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:SHARON
Authorized Official - Last Name:BARNETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-696-6478
Mailing Address - Street 1:2501 BLUE RIDGE RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6479
Mailing Address - Country:US
Mailing Address - Phone:919-696-6478
Mailing Address - Fax:919-863-4101
Practice Address - Street 1:2501 BLUE RIDGE RD
Practice Address - Street 2:SUITE 250
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6479
Practice Address - Country:US
Practice Address - Phone:919-696-6478
Practice Address - Fax:919-863-4101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-09
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6103832251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC138746OtherNCCITYRAL