Individual
JEANNE NAKAZAWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPCC, NCC
Contact information
Practice address
292 GLADES RD STE 8, BEREA, KY 40403-1368
(859) 985-7862
Mailing address
PO BOX 802, BEREA, KY 40403-0802
(859) 985-7862
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
246414
KY
101YP2500X
Professional Counselor
246414
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100606150
—
KY
Enumeration date
01/24/2017
Last updated
11/07/2019
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