Provider Demographics
NPI:1780939629
Name:POWELL, JANIS A (LCSW)
Entity type:Individual
Prefix:MS
First Name:JANIS
Middle Name:A
Last Name:POWELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:5333 ZELZAH AVE
Mailing Address - Street 2:342
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-2221
Mailing Address - Country:US
Mailing Address - Phone:818-643-1836
Mailing Address - Fax:818-578-8653
Practice Address - Street 1:4405 W RIVERSIDE DR
Practice Address - Street 2:SUITE 209
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4072
Practice Address - Country:US
Practice Address - Phone:818-643-1836
Practice Address - Fax:818-578-8653
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-17
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05471900104100000X
CA33344104100000X
CA70414104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker