Provider Demographics
NPI:1801198932
Name:JANES, COURTNEY LEE (LPC-I)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:LEE
Last Name:JANES
Suffix:
Gender:F
Credentials:LPC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 S INDUSTRIAL BLVD
Mailing Address - Street 2:SUITE 307
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76040-5048
Mailing Address - Country:US
Mailing Address - Phone:817-360-0554
Mailing Address - Fax:817-684-0233
Practice Address - Street 1:610 S INDUSTRIAL BLVD
Practice Address - Street 2:SUITE 307
Practice Address - City:EULESS
Practice Address - State:TX
Practice Address - Zip Code:76040-5048
Practice Address - Country:US
Practice Address - Phone:817-360-0554
Practice Address - Fax:817-684-0233
Is Sole Proprietor?:No
Enumeration Date:2010-11-22
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65300101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor