Provider Demographics
NPI:1255117529
Name:JTA COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:JTA COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMILA
Authorized Official - Middle Name:T
Authorized Official - Last Name:ABDUR-RAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:734-945-9855
Mailing Address - Street 1:13 N WASHINGTON ST STE 144
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-2617
Mailing Address - Country:US
Mailing Address - Phone:734-999-0185
Mailing Address - Fax:
Practice Address - Street 1:13 N WASHINGTON ST STE 144
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-2617
Practice Address - Country:US
Practice Address - Phone:734-999-0185
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-04
Last Update Date:2023-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty