Provider Demographics
NPI:1871253666
Name:JT MUMMERT CONSULTING LLC
Entity Type:Organization
Organization Name:JT MUMMERT CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUMMERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-660-4101
Mailing Address - Street 1:130 E MAIN ST STE 104
Mailing Address - Street 2:
Mailing Address - City:LOCK HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:17745-1326
Mailing Address - Country:US
Mailing Address - Phone:570-660-4101
Mailing Address - Fax:
Practice Address - Street 1:130 E MAIN ST STE 104
Practice Address - Street 2:
Practice Address - City:LOCK HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17745-1326
Practice Address - Country:US
Practice Address - Phone:570-660-4101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-21
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health