Provider Demographics
NPI:1336290832
Name:JADLOWSKI, JANICE MARY (LCSW)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:MARY
Last Name:JADLOWSKI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 E MARTIN LUTHER KING JR DR
Mailing Address - Street 2:SUITE #204
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-4864
Mailing Address - Country:US
Mailing Address - Phone:727-409-3825
Mailing Address - Fax:
Practice Address - Street 1:905 E MARTIN LUTHER KING JR DR
Practice Address - Street 2:SUITE 204
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-4864
Practice Address - Country:US
Practice Address - Phone:727-409-3825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCAP 903101YA0400X
FLSW70291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical