Provider Demographics
NPI:1205005600
Name:SECOR, JENNIFER K (LPC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:K
Last Name:SECOR
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:K
Other - Last Name:KURE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:115 S SYCAMORE ST
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:KS
Mailing Address - Zip Code:66030-1348
Mailing Address - Country:US
Mailing Address - Phone:913-375-8165
Mailing Address - Fax:913-592-2414
Practice Address - Street 1:115 S SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:KS
Practice Address - Zip Code:66030-1348
Practice Address - Country:US
Practice Address - Phone:913-375-8165
Practice Address - Fax:913-592-2414
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-29
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
KS824106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist