Provider Demographics
NPI:1962182121
Name:JEEVA COUNSELING, LLC
Entity type:Organization
Organization Name:JEEVA COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JITHIN
Authorized Official - Middle Name:
Authorized Official - Last Name:VIJAYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPCC
Authorized Official - Phone:937-443-7019
Mailing Address - Street 1:204 LOOKOUT DR
Mailing Address - Street 2:
Mailing Address - City:OAKWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45419-3812
Mailing Address - Country:US
Mailing Address - Phone:937-443-7019
Mailing Address - Fax:937-353-9386
Practice Address - Street 1:204 LOOKOUT DR
Practice Address - Street 2:
Practice Address - City:OAKWOOD
Practice Address - State:OH
Practice Address - Zip Code:45419-3812
Practice Address - Country:US
Practice Address - Phone:937-443-7019
Practice Address - Fax:937-353-9386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-24
Last Update Date:2024-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC010866OtherPENNSYLVANIA STATE BOARD OF SOCIAL WORKERS, MFTS, AND PROFESSIONAL COUNSELORS
OHE.2404286OtherOHIO COUNSELOR, SOCIAL WORKER, AND MARRIAGE AND FAMILY THERAPIST BOARD
ARP2303011OtherARKANSAS BOARD OF EXAMINERS IN COUNSELING AND MARRIAGE AND FAMILY THERAPY
VT068.0134892TELEOtherVERMONT OFFICE OF PROFESSIONAL REGULATION