Healthcare Provider Details

I. General information

NPI: 1447636139
Provider Name (Legal Business Name): JENNIFER BARBOUR LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2015
Last Update Date: 07/20/2021
Certification Date: 07/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21350 W 153RD ST
OLATHE KS
66061-5413
US

IV. Provider business mailing address

21350 W 153RD ST
OLATHE KS
66061-5413
US

V. Phone/Fax

Practice location:
  • Phone: 913-322-4900
  • Fax: 913-780-1284
Mailing address:
  • Phone: 913-322-4900
  • Fax: 913-780-1284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number2792
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2021019544
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: