MEDICARE: LORETTA A. JASPER LCPC

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	101YM0800X	Mental Health Counselor	LCPC	KS

General Provider Information

NPI Number	:	1447325519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORETTA A. JASPER LCPC

Provider Business Mailing Address
First Line	:	5427 JOHNSON DR
Second Line	:	#175
City	:	MISSION
State	:	KS
Zip	:	66205-2912
Country	:	US
Telephone Number	:	816-645-5222
Fax Number	:	913-383-3001

Provider Business Practice Location Address
First Line	:	8900 STATE LINE RD
Second Line	:	#435
City	:	LEAWOOD
State	:	KS
Zip	:	66206-1941
Country	:	US
Telephone Number	:	816-645-5222
Fax Number	:	913-383-3001

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

Provider Enumeration Date	:	11/22/2006
Last Update Date	:	07/08/2007

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