Provider Demographics
NPI:1982654786
Name:JENNINGS, JAMES ALAN (LSCSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ALAN
Last Name:JENNINGS
Suffix:
Gender:M
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8826 SANTA FE DR
Mailing Address - Street 2:SUITE 215
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-3655
Mailing Address - Country:US
Mailing Address - Phone:913-221-4949
Mailing Address - Fax:913-649-1615
Practice Address - Street 1:8826 SANTA FE DR
Practice Address - Street 2:SUITE 215
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-3655
Practice Address - Country:US
Practice Address - Phone:913-221-4949
Practice Address - Fax:913-649-1615
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS07241041C0700X
MO0019031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0002249Medicare ID - Type Unspecified