Provider Demographics
NPI:1619171055
Name:JL COUNSELING
Entity Type:Organization
Organization Name:JL COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:505-831-2591
Mailing Address - Street 1:5516 OVERLOOK DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-1881
Mailing Address - Country:US
Mailing Address - Phone:505-235-4756
Mailing Address - Fax:505-831-2591
Practice Address - Street 1:5516 OVERLOOK DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-1881
Practice Address - Country:US
Practice Address - Phone:505-235-4756
Practice Address - Fax:505-831-2591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI060701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM1134179120OtherINDIVIDUAL NPI #