Provider Demographics
NPI:1083077820
Name:FRONCZAK, JANICE (RDT, PLMHP, NCC)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:FRONCZAK
Suffix:
Gender:F
Credentials:RDT, PLMHP, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 W 34TH ST
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-2761
Mailing Address - Country:US
Mailing Address - Phone:308-455-0219
Mailing Address - Fax:
Practice Address - Street 1:2315 W 39TH ST
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-8327
Practice Address - Country:US
Practice Address - Phone:308-455-0219
Practice Address - Fax:877-345-3501
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-30
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10815101YM0800X
NE20481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health