Provider Demographics
NPI:1477756179
Name:JANELLE ALLEN, PSY.D.
Entity Type:Organization
Organization Name:JANELLE ALLEN, PSY.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JANELLE
Authorized Official - Middle Name:W
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:608-513-0399
Mailing Address - Street 1:313 PRICE PL
Mailing Address - Street 2:SUITE 108
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-3299
Mailing Address - Country:US
Mailing Address - Phone:608-513-0399
Mailing Address - Fax:
Practice Address - Street 1:313 PRICE PL
Practice Address - Street 2:SUITE 108
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-3299
Practice Address - Country:US
Practice Address - Phone:608-513-0399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1930-057103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39138000Medicaid