Provider Demographics
NPI:1760986343
Name:PERSONAL COUNSELING & WELLNESS, LLC
Entity Type:Organization
Organization Name:PERSONAL COUNSELING & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:JAROS
Authorized Official - Suffix:
Authorized Official - Credentials:LISW, LCSW
Authorized Official - Phone:440-862-0871
Mailing Address - Street 1:9999 GRANGER RD STE 2
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-5319
Mailing Address - Country:US
Mailing Address - Phone:440-862-0871
Mailing Address - Fax:
Practice Address - Street 1:9999 GRANGER RD STE 2
Practice Address - Street 2:
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44125
Practice Address - Country:US
Practice Address - Phone:440-862-0871
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-20
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.08002371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty