Provider Demographics
NPI:1851526016
Name:J W COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:J W COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANNIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:618-444-8761
Mailing Address - Street 1:643 TAMARACH
Mailing Address - Street 2:
Mailing Address - City:EDWARDSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62025-5250
Mailing Address - Country:US
Mailing Address - Phone:618-637-9030
Mailing Address - Fax:618-637-9030
Practice Address - Street 1:20 A PROFESSIONAL PARK DRIVE
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62062
Practice Address - Country:US
Practice Address - Phone:618-288-8787
Practice Address - Fax:618-288-0737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-18
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty