Healthcare Provider Details

I. General information

NPI: 1437962677
Provider Name (Legal Business Name): JENNA NICHOLE HOUCHIN LMLP-CB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNA NICHOLE OSTROSKY

II. Dates (important events)

Enumeration Date: 01/30/2025
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1730 BELMONT AVE
PARSONS KS
67357-4229
US

IV. Provider business mailing address

1730 BELMONT AVE
PARSONS KS
67357-4229
US

V. Phone/Fax

Practice location:
  • Phone: 620-421-3770
  • Fax: 620-421-3770
Mailing address:
  • Phone: 620-421-3770
  • Fax: 620-421-3770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number03392
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number03392
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: