Provider Demographics
NPI:1598199390
Name:TWIGG, JENNIFER LESLIE (MA, LPC, CCDP-D,MARS)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:LESLIE
Last Name:TWIGG
Suffix:
Gender:F
Credentials:MA, LPC, CCDP-D,MARS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 NE RICE RD
Mailing Address - Street 2:
Mailing Address - City:LEE'S SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086
Mailing Address - Country:US
Mailing Address - Phone:816-347-3609
Mailing Address - Fax:
Practice Address - Street 1:3211 WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64109-2073
Practice Address - Country:US
Practice Address - Phone:816-554-4245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013000299101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional