Provider Demographics
NPI:1043544588
Name:JANCEK, JULIA E (LMHC)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:E
Last Name:JANCEK
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1624 FERRIS AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-1810
Mailing Address - Country:US
Mailing Address - Phone:321-662-6351
Mailing Address - Fax:
Practice Address - Street 1:1543 LAKE BALDWIN LN
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32814-6695
Practice Address - Country:US
Practice Address - Phone:407-894-5202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9813101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health