Provider Demographics
NPI:1407152291
Name:COON, JENNIFER A (LMSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:A
Last Name:COON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:A
Other - Last Name:KLEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSW
Mailing Address - Street 1:10500 BARKLEY ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-1811
Mailing Address - Country:US
Mailing Address - Phone:913-642-4300
Mailing Address - Fax:
Practice Address - Street 1:10500 BARKLEY ST
Practice Address - Street 2:SUITE 210
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-1811
Practice Address - Country:US
Practice Address - Phone:913-642-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-27
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS7847104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker