Provider Demographics
NPI:1043036528
Name:JLM PROFESSIONAL SERVICES LLC
Entity type:Organization
Organization Name:JLM PROFESSIONAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:MICHEL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:417-464-8881
Mailing Address - Street 1:PO BOX 243
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:MO
Mailing Address - Zip Code:65721-0243
Mailing Address - Country:US
Mailing Address - Phone:417-464-8881
Mailing Address - Fax:
Practice Address - Street 1:1310 W SCHOOL ST
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:MO
Practice Address - Zip Code:65721-6618
Practice Address - Country:US
Practice Address - Phone:417-464-8881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-29
Last Update Date:2024-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty