Provider Demographics
NPI:1063279578
Name:JW COUNSELING PLLC
Entity type:Organization
Organization Name:JW COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSIE
Authorized Official - Middle Name:AMBER
Authorized Official - Last Name:WATTS GOGG
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:704-530-8341
Mailing Address - Street 1:2485 N NC 16 BUSINESS HWY STE 100
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:NC
Mailing Address - Zip Code:28037-8256
Mailing Address - Country:US
Mailing Address - Phone:704-530-8341
Mailing Address - Fax:
Practice Address - Street 1:2485 N NC 16 BUSINESS HWY STE 100
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:NC
Practice Address - Zip Code:28037-8256
Practice Address - Country:US
Practice Address - Phone:704-530-8341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-01
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty