| Jeremiah Johnson Lcpc Llc | |
|
1505 Kasold Dr Ste 8 Lawrence KS 66047-1601 | |
| (785) 542-9110 | |
| Not Available |
| Full Name | Jeremiah Johnson Lcpc Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1505 Kasold Dr Ste 8, Lawrence, Kansas |
| Authorized Official Name and Position | Jeremiah Johnson (OWNER/PROVIDER) |
| Authorized Official Contact | 7855429110 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeremiah Johnson Lcpc Llc 1505 Kasold Dr Ste 8 Lawrence KS 66047-1601 Ph: (785) 542-9110 | Jeremiah Johnson Lcpc Llc 1505 Kasold Dr Ste 8 Lawrence KS 66047-1601 Ph: (785) 542-9110 |
| NPI Number | 1932977006 |
|---|---|
| Provider Enumeration Date | 12/18/2023 |
| Last Update Date | 12/18/2023 |
| Certification Date | 12/18/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932977006 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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