Provider Demographics
NPI:1275323412
Name:DR. B. JUSTILIEN COUNSELING LLC
Entity type:Organization
Organization Name:DR. B. JUSTILIEN COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:JUSTILIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-833-1849
Mailing Address - Street 1:73 SHINING WATER LN
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:NC
Mailing Address - Zip Code:28390-7007
Mailing Address - Country:US
Mailing Address - Phone:305-833-1849
Mailing Address - Fax:
Practice Address - Street 1:1487 2ND ST # C-5
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-4911
Practice Address - Country:US
Practice Address - Phone:305-833-1849
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-09
Last Update Date:2025-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty