Provider Demographics
NPI:1982811089
Name:SHULTS, JANELLE CHRISTINA (MSW)
Entity Type:Individual
Prefix:MRS
First Name:JANELLE
Middle Name:CHRISTINA
Last Name:SHULTS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 POLSIN DRIVE
Mailing Address - Street 2:
Mailing Address - City:ROTTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12303
Mailing Address - Country:US
Mailing Address - Phone:518-482-2455
Mailing Address - Fax:518-482-2458
Practice Address - Street 1:845 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12206-1504
Practice Address - Country:US
Practice Address - Phone:518-482-2455
Practice Address - Fax:518-482-2458
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)