Provider Demographics
NPI:1205094638
Name:AJAYA, JANE E (MSW)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:E
Last Name:AJAYA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:E
Other - Last Name:CROOKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSED
Mailing Address - Street 1:1644 SLAUGHTER RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-8610
Mailing Address - Country:US
Mailing Address - Phone:256-325-1690
Mailing Address - Fax:256-325-2090
Practice Address - Street 1:300 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-3818
Practice Address - Country:US
Practice Address - Phone:707-217-9248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0174901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
309659Medicare UPIN