Provider Demographics
NPI:1346137957
Name:WONNELL, JEWELL (LPC)
Entity type:Individual
Prefix:
First Name:JEWELL
Middle Name:
Last Name:WONNELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:PLANKINTON
Mailing Address - State:SD
Mailing Address - Zip Code:57368-2033
Mailing Address - Country:US
Mailing Address - Phone:816-277-7706
Mailing Address - Fax:
Practice Address - Street 1:1400 E 10TH ST
Practice Address - Street 2:
Practice Address - City:PLANKINTON
Practice Address - State:SD
Practice Address - Zip Code:57368-2033
Practice Address - Country:US
Practice Address - Phone:816-277-7706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD20625101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional