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NPI Code Detail

MEDICARE: JACLYNNE MCCRILLIS LPC, NCC

MEDICARE: JACLYNNE MCCRILLIS LPC, NCC
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
1101YP2500XProfessional Counselor03891KS

General Provider Information

NPI Number : 1609545235
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACLYNNE MCCRILLIS LPC, NCC
Provider Business Mailing Address
First Line : 7247 CONSER ST
Second Line :
City : OVERLAND PARK
State : KS
Zip : 66204-1823
Country : US
Telephone Number : 913-972-4278
Fax Number :
Provider Business Practice Location Address
First Line : 9401 INDIAN CREEK PKWY STE 520
Second Line :
City : OVERLAND PARK
State : KS
Zip : 66210-2013
Country : US
Telephone Number : 913-972-4278
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2021
Last Update Date : 09/08/2021

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Directions to “ JACLYNNE MCCRILLIS LPC, NCC” Practice Location

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