Provider Demographics
NPI:1871657064
Name:NADLER, JANIS CELE (LICSW)
Entity Type:Individual
Prefix:MS
First Name:JANIS
Middle Name:CELE
Last Name:NADLER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 CHASE ST
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05301-2973
Mailing Address - Country:US
Mailing Address - Phone:802-451-3535
Mailing Address - Fax:
Practice Address - Street 1:109 SUNNY ACRES ST
Practice Address - Street 2:
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-6921
Practice Address - Country:US
Practice Address - Phone:802-451-3535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT08900006431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30423660Medicaid
VT1010898Medicaid