Provider Demographics
NPI:1003140781
Name:MAHER JURADO, FAYE CLARE (LPC & LMAC)
Entity Type:Individual
Prefix:MS
First Name:FAYE
Middle Name:CLARE
Last Name:MAHER JURADO
Suffix:
Gender:F
Credentials:LPC & LMAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12311 W 79TH TER
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-2603
Mailing Address - Country:US
Mailing Address - Phone:913-203-8939
Mailing Address - Fax:
Practice Address - Street 1:6331 W 110TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1509
Practice Address - Country:US
Practice Address - Phone:913-696-1911
Practice Address - Fax:913-696-1619
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-28
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS697101YA0400X
KS2139101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS101YA0400XMedicaid