Provider Demographics
NPI:1902955784
Name:SPITZER, JANIS (LCSW, ATR-BC)
Entity Type:Individual
Prefix:
First Name:JANIS
Middle Name:
Last Name:SPITZER
Suffix:
Gender:F
Credentials:LCSW, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1621 METROPOLITAN BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-3792
Mailing Address - Country:US
Mailing Address - Phone:850-386-9313
Mailing Address - Fax:850-422-2469
Practice Address - Street 1:1621 METROPOLITAN BLVD STE D
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-3792
Practice Address - Country:US
Practice Address - Phone:850-386-9313
Practice Address - Fax:850-422-2469
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW80811041C0700X
FL97-043221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist