Provider Demographics
NPI:1376034645
Name:MONGAR, JANEEN (LPC, LMT)
Entity Type:Individual
Prefix:
First Name:JANEEN
Middle Name:
Last Name:MONGAR
Suffix:
Gender:F
Credentials:LPC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6510 S ACADEMY BLVD STE 271A
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-7601
Mailing Address - Country:US
Mailing Address - Phone:719-231-6187
Mailing Address - Fax:
Practice Address - Street 1:6510 S ACADEMY BLVD STE 271A
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-7601
Practice Address - Country:US
Practice Address - Phone:719-231-6187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0021583225700000X
COLPC.0005429101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist