Wallen, Jane Burgess

Wallen, Jane Burgess is an individual health care provider with primary practice located at 60 Professional Park Dr , Louisa KY 41230-9644. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Wallen, Jane Burgess can be contacted via phone (606) 638-4332.

Contact Information

Primary practice address
60 Professional Park Dr Louisa KY 41230-9644
Phone: (606) 638-4332
Fax: (606) 638-4394
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X KY-1263 Kentucky

Profile Details

NPI number 1245258383
LBN Legal business name Wallen, Jane Burgess
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2006
Last updated Nov 7th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245258383 NPPES
Other 001723358 MSBCBS
MEDICAID 7100282900 MSBCBS
Other 610661987 MSBCBS
Other 1175490 MSBCBS
Other 000000207306 MSBCBS
Other 11491126 MSBCBS
Other 279403 MSBCBS

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