Jewel A Anderson, LCPC

Individual provider Active NPI Professional Counselor · Overland Park, KS

NPI 1508515834 · NPPES record last updated Mar 23, 2022

Key facts

NPI
1508515834
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
03179 (KS)
Practice address
5750 W 95TH St Ste 155
Overland Park, KS 66207-2980
Phone
(913) 295-9945
NPI assigned
Mar 23, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
03179KSMDPsychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 03179 KS Yes

Addresses

Primary practice location

5750 W 95TH St Ste 155
Overland Park, KS 66207-2980

Mailing address

4812 W 70TH St
Prairie Village, KS 66208-2003
Phone (913) 940-8791

Other providers in Overland Park, KS

All providers in Overland Park, KS · Professional Counselor in Kansas

Sources for this page

Verify at the official NPI Registry.