| Crj Counseling, Llc | |
|
2006 1st Ave Dodge City KS 67801-2623 | |
| (620) 371-6548 | |
| (620) 371-7119 |
| Full Name | Crj Counseling, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2006 1st Ave, Dodge City, Kansas |
| Authorized Official Name and Position | Cindy Renee Jacobs (OWNER/THERAPIST) |
| Authorized Official Contact | 6203716548 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crj Counseling, Llc 2006 1st Ave Dodge City KS 67801-2623 Ph: (620) 371-6548 | Crj Counseling, Llc 2006 1st Ave Dodge City KS 67801-2623 Ph: (620) 371-6548 |
| NPI Number | 1902292469 |
|---|---|
| Provider Enumeration Date | 04/11/2015 |
| Last Update Date | 04/11/2015 |
| Medicare PECOS PAC ID | 2860842234 |
|---|---|
| Medicare Enrollment ID | O20231227001922 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902292469 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LCPC2407 (Kansas) | Primary |
| 251S00000X | Community/behavioral Health | LAC1019 (Kansas) | Secondary |
| Provider Name | Cindy R Jacobs |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114103223 PECOS PAC ID: 0941650311 Enrollment ID: I20231227002059 |
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