Provider Demographics
NPI:1811764111
Name:DR JUSTICE COUNSELING AND CONSULTING, LLC
Entity type:Organization
Organization Name:DR JUSTICE COUNSELING AND CONSULTING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:M
Authorized Official - Last Name:JUSTICE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD,LPCC-S
Authorized Official - Phone:174-093-5408
Mailing Address - Street 1:135 E HURON ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:OH
Mailing Address - Zip Code:45640-1976
Mailing Address - Country:US
Mailing Address - Phone:740-935-4085
Mailing Address - Fax:
Practice Address - Street 1:135 E HURON ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:OH
Practice Address - Zip Code:45640-1976
Practice Address - Country:US
Practice Address - Phone:740-935-4085
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-06
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty