Provider Demographics
NPI:1750516902
Name:EKOLA, JIMMIE LYNN (LMSW)
Entity type:Individual
Prefix:MRS
First Name:JIMMIE
Middle Name:LYNN
Last Name:EKOLA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10324 BALLYMOTE DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-4344
Mailing Address - Country:US
Mailing Address - Phone:915-595-4320
Mailing Address - Fax:
Practice Address - Street 1:10324 BALLYMOTE DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-4344
Practice Address - Country:US
Practice Address - Phone:915-861-6287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-18
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX52473104100000X, 101Y00000X
TX12058101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)