Provider Demographics
NPI:1255710539
Name:JANELLE LITWAK, MFT
Entity type:Organization
Organization Name:JANELLE LITWAK, MFT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:JANELLE
Authorized Official - Middle Name:VICTORIA
Authorized Official - Last Name:LITWAK
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:626-710-0143
Mailing Address - Street 1:537 WICKLIFFE DR
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-1257
Mailing Address - Country:US
Mailing Address - Phone:626-710-0143
Mailing Address - Fax:866-401-2658
Practice Address - Street 1:16 S OAKLAND AVE
Practice Address - Street 2:SUITE 214
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2043
Practice Address - Country:US
Practice Address - Phone:626-710-0143
Practice Address - Fax:866-401-2658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-20
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40387106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty