Provider Demographics
NPI:1164248134
Name:CHAGOYAN, JOHN P (PLPC, NCC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:CHAGOYAN
Suffix:
Gender:M
Credentials:PLPC, NCC
Other - Prefix:
Other - First Name:JOHNNY
Other - Middle Name:
Other - Last Name:CHAGOYAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:400 SW LONGVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64081-2103
Mailing Address - Country:US
Mailing Address - Phone:816-761-3944
Mailing Address - Fax:
Practice Address - Street 1:400 SW LONGVIEW BLVD
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64081-2103
Practice Address - Country:US
Practice Address - Phone:816-761-3944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024046016101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional