Provider Demographics
NPI:1275842635
Name:INSERRA, JOHN F JR (LPCC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:F
Last Name:INSERRA
Suffix:JR
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 ROCKWOOD LN
Mailing Address - Street 2:
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41701-9415
Mailing Address - Country:US
Mailing Address - Phone:606-436-5761
Mailing Address - Fax:606-435-0817
Practice Address - Street 1:3830 HIGHWAY 15 S
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:KY
Practice Address - Zip Code:41339-8675
Practice Address - Country:US
Practice Address - Phone:606-436-5761
Practice Address - Fax:606-436-5797
Is Sole Proprietor?:No
Enumeration Date:2010-10-04
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY103993101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health