Provider Demographics
NPI:1245092469
Name:JAN ABENDROTH COUNSELING LLC
Entity type:Organization
Organization Name:JAN ABENDROTH COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:ABENDROTH
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:515-669-2522
Mailing Address - Street 1:6165 NW 86TH ST # 2332
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-2270
Mailing Address - Country:US
Mailing Address - Phone:515-669-2522
Mailing Address - Fax:
Practice Address - Street 1:6165 NW 86TH ST # 2332
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131-2270
Practice Address - Country:US
Practice Address - Phone:515-669-2522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty