Provider Demographics
NPI:1568414639
Name:SALMONS, JENNIFER (LPC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:SALMONS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1508 NW VIVION RD STE 311
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64118-4557
Mailing Address - Country:US
Mailing Address - Phone:816-529-7784
Mailing Address - Fax:816-222-0404
Practice Address - Street 1:1508 NW VIVION RD STE 311
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64118-4557
Practice Address - Country:US
Practice Address - Phone:816-529-7784
Practice Address - Fax:816-222-0404
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004017130101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2004017130OtherLPC LICENSE
MO11653034OtherCAQH #