Provider Demographics
NPI:1619553831
Name:CONCEPTUAL COUNSELING LLC
Entity Type:Organization
Organization Name:CONCEPTUAL COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOYL
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:208-512-5085
Mailing Address - Street 1:1620 NORTHWEST BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-2488
Mailing Address - Country:US
Mailing Address - Phone:208-512-5085
Mailing Address - Fax:800-865-1927
Practice Address - Street 1:1620 NORTHWEST BLVD STE 101
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2488
Practice Address - Country:US
Practice Address - Phone:208-512-5085
Practice Address - Fax:800-865-1927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-18
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty