Provider Demographics
NPI:1376913020
Name:JOHNSON, JANELLE (MA)
Entity Type:Individual
Prefix:
First Name:JANELLE
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 S TROY ST
Mailing Address - Street 2:BUILDING 5, SUITE 256
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-1946
Mailing Address - Country:US
Mailing Address - Phone:720-940-9299
Mailing Address - Fax:
Practice Address - Street 1:2323 S TROY ST
Practice Address - Street 2:BUILDING 5, SUITE 256
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1946
Practice Address - Country:US
Practice Address - Phone:720-940-9299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-06
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONLC-13409101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health