Provider Demographics
NPI:1023237534
Name:JANCZUNSKI, CARA LYNN (ATR, LMHC)
Entity type:Individual
Prefix:MS
First Name:CARA
Middle Name:LYNN
Last Name:JANCZUNSKI
Suffix:
Gender:F
Credentials:ATR, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 WILBUR ST
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:MA
Mailing Address - Zip Code:02766-1806
Mailing Address - Country:US
Mailing Address - Phone:508-285-3677
Mailing Address - Fax:
Practice Address - Street 1:19 CEDAR ST
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-3301
Practice Address - Country:US
Practice Address - Phone:508-823-6124
Practice Address - Fax:508-880-6507
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2009-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6895101YM0800X
221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist