Provider Demographics
NPI:1487892469
Name:JANIT, ADRIAN STANFORD (PHD)
Entity type:Individual
Prefix:DR
First Name:ADRIAN
Middle Name:STANFORD
Last Name:JANIT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 PLEASANT HOME RD STE G1
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30907-0560
Mailing Address - Country:US
Mailing Address - Phone:706-364-4599
Mailing Address - Fax:706-364-4589
Practice Address - Street 1:211 PLEASANT HOME RD STE G1
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30907-0560
Practice Address - Country:US
Practice Address - Phone:706-364-4599
Practice Address - Fax:706-364-4589
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-28
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY003347103TA0400X, 103TC0700X, 103TC2200X, 103TF0000X, 103TP2701X, 103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA478699634BMedicaid