Individual
JENNIFER GILLENWATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSWT, LAC
Contact information
Practice address
128 S CONSTITUTION ST, EMPORIA, KS 66801-4621
(620) 366-9444
Mailing address
128 S CONSTITUTION ST, EMPORIA, KS 66801-4621
(620) 366-9444
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
01751
KS
104100000X
Social Worker
Primary
13485-T
KS
Other
Enumeration date
02/09/2024
Last updated
02/09/2024
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