Provider Demographics
NPI:1952847444
Name:JANE L. JOHNSON, LLC
Entity Type:Organization
Organization Name:JANE L. JOHNSON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:970-266-2678
Mailing Address - Street 1:2627 REDWING RD STE 235
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-6352
Mailing Address - Country:US
Mailing Address - Phone:970-266-2678
Mailing Address - Fax:970-631-8873
Practice Address - Street 1:2627 REDWING RD STE 235
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-6352
Practice Address - Country:US
Practice Address - Phone:970-266-2678
Practice Address - Fax:970-631-8873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-09
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9891571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty