Provider Demographics
NPI:1548748312
Name:JANE O. ORTON, LICSW, LLC
Entity type:Organization
Organization Name:JANE O. ORTON, LICSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:O
Authorized Official - Last Name:ORTON
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:256-797-6623
Mailing Address - Street 1:718 TANNAHILL DR. SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802-1954
Mailing Address - Country:US
Mailing Address - Phone:256-797-6623
Mailing Address - Fax:
Practice Address - Street 1:120 HOLMES AVE NE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801
Practice Address - Country:US
Practice Address - Phone:256-797-6623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-02
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1422C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL33000000014Medicaid