Provider Demographics
NPI:1740766872
Name:MENEFEE, JANALISA (LPC)
Entity Type:Individual
Prefix:
First Name:JANALISA
Middle Name:
Last Name:MENEFEE
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 1:7507 TAYSIDE DR
Mailing Address - Street 2:
Mailing Address - City:BLACKLICK
Mailing Address - State:OH
Mailing Address - Zip Code:43004-9780
Mailing Address - Country:US
Mailing Address - Phone:614-501-8985
Mailing Address - Fax:
Practice Address - Street 1:5310 E MAIN ST STE 102
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-2598
Practice Address - Country:US
Practice Address - Phone:614-751-1090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1100093101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional