Provider Demographics
NPI:1225240807
Name:GIALANELLA, JACK (BA)
Entity Type:Individual
Prefix:MR
First Name:JACK
Middle Name:
Last Name:GIALANELLA
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1065 LOGAN STREET
Mailing Address - Street 2:# 308
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203
Mailing Address - Country:US
Mailing Address - Phone:303-594-8826
Mailing Address - Fax:
Practice Address - Street 1:6509 S. SANTA FE DRIVE
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120
Practice Address - Country:US
Practice Address - Phone:303-797-9343
Practice Address - Fax:303-797-9345
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health