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General NPI Number Information
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NPI Number | 1326547092
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Entity Type | Individual
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Provider Name | JOHN MARTIN HAASE LPC
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Gender | Male
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Dates
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Enumeration Date | 02/07/2018
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 24 N SPRIGG ST # 5526
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City | CAPE GIRARDEAU
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State | MO
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Zip | 63701-5526
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Country | US
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Telephone | 573-332-7992
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Fax | 573-332-7998
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Provider Business Mailing Address
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Address Line | 425 BROADWAY ST
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City | PADUCAH
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State | KY
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Zip | 42001-0713
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Country | US
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Telephone | 270-442-7121
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Fax | 270-442-5729
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 271542
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 2024047770
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License Number State | MO
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