Provider Demographics
NPI:1356191548
Name:HENRY, JANUARY ANGEL (LMHC)
Entity type:Individual
Prefix:
First Name:JANUARY
Middle Name:ANGEL
Last Name:HENRY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:981 CASA DEL SOL CIR
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-7280
Mailing Address - Country:US
Mailing Address - Phone:904-677-6111
Mailing Address - Fax:
Practice Address - Street 1:981 CASA DEL SOL CIR
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-7280
Practice Address - Country:US
Practice Address - Phone:904-677-6111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH23336101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health