Provider Demographics
NPI:1124912902
Name:JMG THERAPY AND COUNSELING
Entity type:Organization
Organization Name:JMG THERAPY AND COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:J
Authorized Official - Last Name:GUSTAFSON
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:515-250-2012
Mailing Address - Street 1:2190 NW 82ND ST STE D
Mailing Address - Street 2:
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-5509
Mailing Address - Country:US
Mailing Address - Phone:515-777-1209
Mailing Address - Fax:515-349-5339
Practice Address - Street 1:2190 NW 82ND ST STE D
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-5509
Practice Address - Country:US
Practice Address - Phone:515-777-1209
Practice Address - Fax:515-349-5339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty