Provider Demographics
NPI:1083313407
Name:JANOS, KELLY
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:JANOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4731 ROUTE 30 STE 304
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-7260
Mailing Address - Country:US
Mailing Address - Phone:724-537-8100
Mailing Address - Fax:
Practice Address - Street 1:4731 ROUTE 30 STE 304
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-7260
Practice Address - Country:US
Practice Address - Phone:724-537-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW139609104100000X
PABH001516103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No104100000XBehavioral Health & Social Service ProvidersSocial Worker