Provider Demographics
NPI:1538824016
Name:MOJO COUNSELING SERVICES
Entity type:Organization
Organization Name:MOJO COUNSELING SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER AND LPC
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:JACINTO
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:210-480-3353
Mailing Address - Street 1:4606 CENTERVIEW STE 185
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-1230
Mailing Address - Country:US
Mailing Address - Phone:210-480-3353
Mailing Address - Fax:210-569-6192
Practice Address - Street 1:4606 CENTERVIEW STE 185
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-1230
Practice Address - Country:US
Practice Address - Phone:210-480-3353
Practice Address - Fax:210-569-6192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-01
Last Update Date:2023-08-11
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