Provider Demographics
NPI:1851731996
Name:JANSEN, PIA M (MSW)
Entity Type:Individual
Prefix:
First Name:PIA
Middle Name:M
Last Name:JANSEN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2412 E COUNTY ROAD 62
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:CO
Mailing Address - Zip Code:80549-1508
Mailing Address - Country:US
Mailing Address - Phone:970-227-2855
Mailing Address - Fax:
Practice Address - Street 1:2412 E COUNTY ROAD 62
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:CO
Practice Address - Zip Code:80549-1508
Practice Address - Country:US
Practice Address - Phone:970-227-2855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-03
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical