Provider Demographics
NPI:1952644486
Name:ROWBERRY, JANIS (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JANIS
Middle Name:
Last Name:ROWBERRY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1326 E 720 N
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84606-2087
Mailing Address - Country:US
Mailing Address - Phone:702-503-4410
Mailing Address - Fax:
Practice Address - Street 1:1326 E 720 N
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84606-2087
Practice Address - Country:US
Practice Address - Phone:702-503-4410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-03
Last Update Date:2024-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500796561041C0700X
UT12317012-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical