Provider Demographics
NPI:1295096469
Name:JLS CONSULTING, INC
Entity type:Organization
Organization Name:JLS CONSULTING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:LLOYD
Authorized Official - Last Name:STOLZ
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW, LADC
Authorized Official - Phone:612-799-3696
Mailing Address - Street 1:2736 HENNEPIN AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-1037
Mailing Address - Country:US
Mailing Address - Phone:612-790-0080
Mailing Address - Fax:
Practice Address - Street 1:2736 HENNEPIN AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-1037
Practice Address - Country:US
Practice Address - Phone:612-790-0080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-05
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN160111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN952968300Medicaid