Provider Demographics
NPI:1063915239
Name:JPW COUNSELING & CONSULTATION
Entity type:Organization
Organization Name:JPW COUNSELING & CONSULTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAKE
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERCE-WALSH
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LICSW
Authorized Official - Phone:218-343-3406
Mailing Address - Street 1:302 W SUPERIOR ST STE 508
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55802-5115
Mailing Address - Country:US
Mailing Address - Phone:218-343-3406
Mailing Address - Fax:218-409-7679
Practice Address - Street 1:302 W SUPERIOR ST STE 508
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802
Practice Address - Country:US
Practice Address - Phone:218-260-9237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-14
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty