Provider Demographics
NPI:1710005780
Name:SOWARDS, JANEIL (MA, LPC, LAC)
Entity type:Individual
Prefix:
First Name:JANEIL
Middle Name:
Last Name:SOWARDS
Suffix:
Gender:F
Credentials:MA, LPC, LAC
Other - Prefix:
Other - First Name:NOLA
Other - Middle Name:JANEIL
Other - Last Name:SOWARDS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:812 GRAND AVE STE 215812
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81601-3482
Mailing Address - Country:US
Mailing Address - Phone:970-379-6703
Mailing Address - Fax:
Practice Address - Street 1:812 GRAND AVE STE 215812
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-3482
Practice Address - Country:US
Practice Address - Phone:970-379-6703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3162101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04140091Medicaid