Provider Demographics
NPI:1912395815
Name:CARDOZA, JANET
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:CARDOZA
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:JANET
Other - Middle Name:
Other - Last Name:CARDOZA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCPC
Mailing Address - Street 1:2971 E COPPER POINT DR STE 100
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-9276
Mailing Address - Country:US
Mailing Address - Phone:208-376-5683
Mailing Address - Fax:208-376-5690
Practice Address - Street 1:2971 E COPPER POINT DR STE 100
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-9276
Practice Address - Country:US
Practice Address - Phone:208-376-5683
Practice Address - Fax:208-376-5690
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-30
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-179101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health