Provider Demographics
NPI:1942500780
Name:SPEARS, JOANNA M (MA, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:M
Last Name:SPEARS
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4745 W 136TH ST
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66224-5923
Mailing Address - Country:US
Mailing Address - Phone:816-392-3006
Mailing Address - Fax:
Practice Address - Street 1:4745 W 136TH ST
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66224-5923
Practice Address - Country:US
Practice Address - Phone:816-392-3006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-27
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2195101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor