Provider Demographics
NPI:1740569086
Name:LEMUZ, JESSE JOE JR (LMSW)
Entity Type:Individual
Prefix:
First Name:JESSE
Middle Name:JOE
Last Name:LEMUZ
Suffix:JR
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 E ELM ST
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-2353
Mailing Address - Country:US
Mailing Address - Phone:785-825-0541
Mailing Address - Fax:785-825-0062
Practice Address - Street 1:205 S 4TH ST
Practice Address - Street 2:SUITE G
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-6166
Practice Address - Country:US
Practice Address - Phone:785-587-8818
Practice Address - Fax:785-587-8946
Is Sole Proprietor?:No
Enumeration Date:2011-08-04
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS7336104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker