Provider Demographics
NPI:1922652551
Name:MILHON, JACQUELINE DAWN (LCPC)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:DAWN
Last Name:MILHON
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 1:638 N WHEATLAND PL
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67235-8236
Mailing Address - Country:US
Mailing Address - Phone:316-209-4680
Mailing Address - Fax:
Practice Address - Street 1:946 N WEST ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-1224
Practice Address - Country:US
Practice Address - Phone:316-768-7075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-31
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3467101Y00000X
KS03442101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor