Provider Demographics
NPI:1114279452
Name:JS HOLSWADE COUNSELING LLC
Entity Type:Organization
Organization Name:JS HOLSWADE COUNSELING LLC
Other - Org Name:JS HOLSWADE COUNSELING LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/COUNSLOR
Authorized Official - Prefix:PROF
Authorized Official - First Name:JOHANNA
Authorized Official - Middle Name:S
Authorized Official - Last Name:HOLSWADE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:816-785-5571
Mailing Address - Street 1:8301 STATE LINE RD
Mailing Address - Street 2:STE 205
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-2025
Mailing Address - Country:US
Mailing Address - Phone:816-785-5571
Mailing Address - Fax:816-363-3600
Practice Address - Street 1:8301 STATE LINE RD
Practice Address - Street 2:STE 205
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-2025
Practice Address - Country:US
Practice Address - Phone:816-785-5571
Practice Address - Fax:816-363-3600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-10
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011008766101Y00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty