Provider Demographics
NPI:1003070384
Name:JANICKI, WILLIAM ALLEN (MS, MA)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:ALLEN
Last Name:JANICKI
Suffix:
Gender:M
Credentials:MS, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 HUMBOLDT ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1614
Mailing Address - Country:US
Mailing Address - Phone:303-504-1635
Mailing Address - Fax:303-831-4604
Practice Address - Street 1:1555 HUMBOLDT ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1614
Practice Address - Country:US
Practice Address - Phone:303-504-1635
Practice Address - Fax:303-831-4604
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator