Provider Demographics
NPI:1750429924
Name:JONES-DUKELLIS, JANET (LPC)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:JONES-DUKELLIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:2625 BROGANS BLUFF DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-3566
Mailing Address - Country:US
Mailing Address - Phone:719-264-6835
Mailing Address - Fax:719-590-1575
Practice Address - Street 1:315 N WEBER ST
Practice Address - Street 2:SUITE 300
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-1230
Practice Address - Country:US
Practice Address - Phone:719-264-6835
Practice Address - Fax:719-590-1575
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2771101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO532840COMedicaid