Provider Demographics
NPI:1437395175
Name:WOJASINSKI, JANAE KIMBERLY (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JANAE
Middle Name:KIMBERLY
Last Name:WOJASINSKI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:JANAE
Other - Middle Name:KIMBERLY
Other - Last Name:LYONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:2214 N PECAN ST
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75965-3502
Mailing Address - Country:US
Mailing Address - Phone:936-560-6855
Mailing Address - Fax:936-564-5232
Practice Address - Street 1:2214 N PECAN ST
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965-3502
Practice Address - Country:US
Practice Address - Phone:936-560-6855
Practice Address - Fax:936-564-5232
Is Sole Proprietor?:No
Enumeration Date:2008-12-31
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4361101YP2500X
TX66495101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2120396-01Medicaid