Provider Demographics
NPI:1609620012
Name:CJM COUNSELING AND WELLNESS, LLC
Entity Type:Organization
Organization Name:CJM COUNSELING AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHONTEL
Authorized Official - Middle Name:A JOHNSON
Authorized Official - Last Name:MCCALLUM
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:754-400-0285
Mailing Address - Street 1:10380 SW VILLAGE DR
Mailing Address - Street 2:SUITE 111
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34987
Mailing Address - Country:US
Mailing Address - Phone:754-400-0285
Mailing Address - Fax:
Practice Address - Street 1:10380 SW VILLAGE DR
Practice Address - Street 2:SUITE 111
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34987
Practice Address - Country:US
Practice Address - Phone:754-400-0285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)