Provider Demographics
NPI:1649364597
Name:HEDLUND, JANICE LEE (NCC, LPC)
Entity type:Individual
Prefix:MS
First Name:JANICE
Middle Name:LEE
Last Name:HEDLUND
Suffix:
Gender:F
Credentials:NCC, LPC
Other - Prefix:
Other - First Name:JAN
Other - Middle Name:L
Other - Last Name:HEDLUND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:13065 W MCDOWELL RD
Mailing Address - Street 2:SUITE C-124
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85323
Mailing Address - Country:US
Mailing Address - Phone:623-594-0713
Mailing Address - Fax:623-594-0746
Practice Address - Street 1:13065 W MCDOWELL RD
Practice Address - Street 2:SUITE C-124
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85323
Practice Address - Country:US
Practice Address - Phone:623-594-0713
Practice Address - Fax:623-594-0746
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC10397101Y00000X
CO2768101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor