Provider Demographics
NPI:1831583434
Name:JABBOK CONSULTING LLC
Entity type:Organization
Organization Name:JABBOK CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LAKENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:678-437-4557
Mailing Address - Street 1:40 LAKEBIRCH DR
Mailing Address - Street 2:SUITE 109
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30016-8859
Mailing Address - Country:US
Mailing Address - Phone:678-437-4557
Mailing Address - Fax:
Practice Address - Street 1:165 BURKE ST
Practice Address - Street 2:SUITE 109
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-3463
Practice Address - Country:US
Practice Address - Phone:678-437-4557
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-23
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty