Provider Demographics
NPI:1316068265
Name:PEINE, J JOANN (LSCSW, LMFT)
Entity type:Individual
Prefix:MRS
First Name:J
Middle Name:JOANN
Last Name:PEINE
Suffix:
Gender:F
Credentials:LSCSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18746 BASKERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:KS
Mailing Address - Zip Code:66072-4092
Mailing Address - Country:US
Mailing Address - Phone:913-898-4212
Mailing Address - Fax:913-898-4212
Practice Address - Street 1:18746 BASKERVILLE RD
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:KS
Practice Address - Zip Code:66072-4092
Practice Address - Country:US
Practice Address - Phone:913-898-4212
Practice Address - Fax:913-898-4212
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS16181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical