Provider Demographics
NPI:1407071343
Name:MABLEY, JANICE L (MSSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:JANICE
Middle Name:L
Last Name:MABLEY
Suffix:
Gender:F
Credentials:MSSW, LCSW
Other - Prefix:MISS
Other - First Name:JANICE
Other - Middle Name:KAY
Other - Last Name:LANGENMAYR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4111 BURNET RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-3628
Mailing Address - Country:US
Mailing Address - Phone:512-371-0569
Mailing Address - Fax:512-329-6765
Practice Address - Street 1:4310 MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-3335
Practice Address - Country:US
Practice Address - Phone:512-461-6678
Practice Address - Fax:512-329-6765
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42464101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health