Provider Demographics
NPI:1851320832
Name:ZITELMAN, JANICE RODE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JANICE
Middle Name:RODE
Last Name:ZITELMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:LOUISE
Other - Last Name:RODE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 291481
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78029-1481
Mailing Address - Country:US
Mailing Address - Phone:830-367-2492
Mailing Address - Fax:830-895-2867
Practice Address - Street 1:135 PLAZA DR
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-2230
Practice Address - Country:US
Practice Address - Phone:830-739-3608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX056111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPENDINGMedicare ID - Type Unspecified