Healthcare Provider Details

I. General information

NPI: 1316038227
Provider Name (Legal Business Name): JENNIFER JOSEPH LMLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 10/26/2025
Certification Date: 10/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22214 D ST
WINFIELD KS
67156-7376
US

IV. Provider business mailing address

902 N 2ND ST
ARKANSAS CITY KS
67005-1512
US

V. Phone/Fax

Practice location:
  • Phone: 620-442-4540
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number779
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number931
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: