Provider Demographics
NPI:1255634804
Name:DOUGHERTY, JANET ELIZABETH (MS, LPC)
Entity type:Individual
Prefix:MRS
First Name:JANET
Middle Name:ELIZABETH
Last Name:DOUGHERTY
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 KATHRYN DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-4216
Mailing Address - Country:US
Mailing Address - Phone:214-538-4532
Mailing Address - Fax:
Practice Address - Street 1:105 KATHRYN DR
Practice Address - Street 2:SUITE 400
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-4216
Practice Address - Country:US
Practice Address - Phone:214-538-4532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-20
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64955101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional