MEDICARE: JACLYN ELISE GINN LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LPC04547	KS

General Provider Information

NPI Number	:	1346098514
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACLYN ELISE GINN LPC

Provider Business Mailing Address
First Line	:	3601 SW 29TH ST STE 128
Second Line	:
City	:	TOPEKA
State	:	KS
Zip	:	66614-2054
Country	:	US
Telephone Number	:	785-251-0975
Fax Number	:

Provider Business Practice Location Address
First Line	:	3601 SW 29TH ST STE 128
Second Line	:
City	:	TOPEKA
State	:	KS
Zip	:	66614-2054
Country	:	US
Telephone Number	:	785-251-0975
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2024
Last Update Date	:	04/28/2026

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