Provider Demographics
NPI:1245942622
Name:NALE, JANUARY LEE (LSW)
Entity type:Individual
Prefix:
First Name:JANUARY
Middle Name:LEE
Last Name:NALE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1852 BISBEE AVE
Mailing Address - Street 2:
Mailing Address - City:WATERFORD WORKS
Mailing Address - State:NJ
Mailing Address - Zip Code:08089-1939
Mailing Address - Country:US
Mailing Address - Phone:609-892-1482
Mailing Address - Fax:
Practice Address - Street 1:1852 BISBEE AVE
Practice Address - Street 2:
Practice Address - City:WATERFORD WORKS
Practice Address - State:NJ
Practice Address - Zip Code:08089-1939
Practice Address - Country:US
Practice Address - Phone:609-892-1482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06882300101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health