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Individual

MS. JEANNE LOUISE STAIVISKY

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
CAS, MAC, LPC, LMHC

Contact information

Practice address
BLANCHFIELD ARMY COMMUNITY HOSPITAL, 650 JOEL DRIVE, FORT CAMPBELL, KY 42223-5349
(270) 798-8372
(270) 956-0180
Mailing address
BLANCHFIELD ARMY COMMUNITY HOSPITAL, 650 JOEL DRIVE, FORT CAMPBELL, KY 42223-5349
(270) 798-8372
(270) 956-0180

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39000646A
IN
101YP2500X
Professional Counselor
IL

Other

Enumeration date
02/23/2006
Last updated
09/11/2025
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