Provider Demographics
NPI:1013482504
Name:LOCONSOLO, JACQUELINE MARIA (LCPC)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:MARIA
Last Name:LOCONSOLO
Suffix:
Gender:
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:PO BOX 8123
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-0123
Mailing Address - Country:US
Mailing Address - Phone:913-353-8783
Mailing Address - Fax:
Practice Address - Street 1:7901 CANTERBURY ST
Practice Address - Street 2:
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-4041
Practice Address - Country:US
Practice Address - Phone:913-353-8783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-10
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS03581101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor