Provider Demographics
NPI:1366778110
Name:DOLAN, JANICE D (LCDC)
Entity type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:D
Last Name:DOLAN
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 BILLINGS ST
Mailing Address - Street 2:SUITE 240
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76010-5404
Mailing Address - Country:US
Mailing Address - Phone:817-652-1004
Mailing Address - Fax:817-652-1016
Practice Address - Street 1:214 BILLINGS ST
Practice Address - Street 2:SUITE 240
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76010-5404
Practice Address - Country:US
Practice Address - Phone:817-652-1004
Practice Address - Fax:817-652-1016
Is Sole Proprietor?:No
Enumeration Date:2009-10-29
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0000047101YA0400X
TX2531-A171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator