Provider Demographics
NPI:1447023361
Name:JACOB JOSEPH AND JABEZ FAMILY COUNSELING AND PROFESSIONAL SERVICES GRO
Entity type:Organization
Organization Name:JACOB JOSEPH AND JABEZ FAMILY COUNSELING AND PROFESSIONAL SERVICES GRO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:LA CENA
Authorized Official - Middle Name:LACHELLE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DSW
Authorized Official - Phone:972-803-6950
Mailing Address - Street 1:2655 VILLA CREEK DR STE 201
Mailing Address - Street 2:
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7324
Mailing Address - Country:US
Mailing Address - Phone:972-803-8950
Mailing Address - Fax:951-823-5507
Practice Address - Street 1:2655 VILLA CREEK DR STE 201
Practice Address - Street 2:
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75234-7324
Practice Address - Country:US
Practice Address - Phone:972-803-8950
Practice Address - Fax:951-823-5507
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JACOB JOSEPH AND JABEZ FAMILY COUNSELING AND PROFESSIONAL SERVICES GRO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No405300000XOther Service ProvidersPrevention ProfessionalGroup - Multi-Specialty