Provider Demographics
NPI:1447325519
Name:JASPER, LORETTA A (LCPC)
Entity type:Individual
Prefix:
First Name:LORETTA
Middle Name:A
Last Name:JASPER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5427 JOHNSON DR
Mailing Address - Street 2:#175
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2912
Mailing Address - Country:US
Mailing Address - Phone:816-645-5222
Mailing Address - Fax:913-383-3001
Practice Address - Street 1:8900 STATE LINE RD
Practice Address - Street 2:#435
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66206-1941
Practice Address - Country:US
Practice Address - Phone:816-645-5222
Practice Address - Fax:913-383-3001
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLCPC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health