Provider Demographics
NPI:1972840379
Name:JBG CONSULTING
Entity Type:Organization
Organization Name:JBG CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:GOLDENSOHN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:307-733-8210
Mailing Address - Street 1:PO BOX 664
Mailing Address - Street 2:
Mailing Address - City:TETON VILLAGE
Mailing Address - State:WY
Mailing Address - Zip Code:83025-0664
Mailing Address - Country:US
Mailing Address - Phone:307-733-1453
Mailing Address - Fax:
Practice Address - Street 1:6855 SQUAW CREEK ROAD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:WY
Practice Address - Zip Code:83001
Practice Address - Country:US
Practice Address - Phone:307-733-1453
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Multi-Specialty
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Multi-Specialty
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Multi-Specialty