Provider Demographics
NPI:1386851756
Name:WOMACK, JANELLE ELIZABETH (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JANELLE
Middle Name:ELIZABETH
Last Name:WOMACK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11255 W JEWELL DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-1923
Mailing Address - Country:US
Mailing Address - Phone:303-914-0915
Mailing Address - Fax:303-914-8542
Practice Address - Street 1:2103 S WADSWORTH BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-2641
Practice Address - Country:US
Practice Address - Phone:303-808-5492
Practice Address - Fax:303-914-8542
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4587101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional