Provider Demographics
NPI:1497869176
Name:LEVIS, JANIE TITUS (PHD, LPCC)
Entity Type:Individual
Prefix:MRS
First Name:JANIE
Middle Name:TITUS
Last Name:LEVIS
Suffix:
Gender:F
Credentials:PHD, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4233 MONTGOMERY BLVD NE
Mailing Address - Street 2:SUITE 200-W
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-6749
Mailing Address - Country:US
Mailing Address - Phone:505-884-8040
Mailing Address - Fax:505-884-3230
Practice Address - Street 1:4233 MONTGOMERY BLVD NE
Practice Address - Street 2:SUITE 200-W
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-6749
Practice Address - Country:US
Practice Address - Phone:505-884-8040
Practice Address - Fax:505-884-3230
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMLPCC 3258101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health