Individual
JENNIFER MOSTAFA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LCPC, NCC
Contact information
Practice address
601 GRANT AVE, FORT LEAVENWORTH, KS 66027-1303
(913) 683-8751
Mailing address
601 GRANT AVE, FORT LEAVENWORTH, KS 66027-1303
(913) 683-8751
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LGPC00113
DC
101YP2500X
Professional Counselor
Primary
LCPC03030
KS
101YP2500X
Professional Counselor
PRC15103
DC
Other
Enumeration date
03/23/2016
Last updated
02/15/2023
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