Provider Demographics
NPI:1275791220
Name:HART, JANELLE (MA, NCC)
Entity Type:Individual
Prefix:MISS
First Name:JANELLE
Middle Name:
Last Name:HART
Suffix:
Gender:F
Credentials:MA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2485 FOUNTAINHEAD BLVD
Mailing Address - Street 2:UNIT I-3
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505-8657
Mailing Address - Country:US
Mailing Address - Phone:970-623-6622
Mailing Address - Fax:
Practice Address - Street 1:2485 FOUNTAINHEAD BLVD
Practice Address - Street 2:UNIT I-3
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-8657
Practice Address - Country:US
Practice Address - Phone:970-623-6622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO213355101Y00000X
CO101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool