Provider Demographics
NPI:1376748111
Name:PRIOR, JAYNE C (LCPC)
Entity Type:Individual
Prefix:
First Name:JAYNE
Middle Name:C
Last Name:PRIOR
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 1:10812 W 128TH PL
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-4520
Mailing Address - Country:US
Mailing Address - Phone:913-486-8099
Mailing Address - Fax:913-685-3065
Practice Address - Street 1:10812 W 128TH PL
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-4520
Practice Address - Country:US
Practice Address - Phone:913-486-8099
Practice Address - Fax:913-685-3065
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS364101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional