Provider Demographics
NPI:1861913659
Name:JEFFREY, JANELLE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:JANELLE
Middle Name:
Last Name:JEFFREY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 COMMANCHE CT
Mailing Address - Street 2:
Mailing Address - City:JUNCTION CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66441-9777
Mailing Address - Country:US
Mailing Address - Phone:785-210-9619
Mailing Address - Fax:
Practice Address - Street 1:1013 W 8TH ST STE A
Practice Address - Street 2:
Practice Address - City:JUNCTION CITY
Practice Address - State:KS
Practice Address - Zip Code:66441-2281
Practice Address - Country:US
Practice Address - Phone:785-210-9619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-30
Last Update Date:2017-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS10466103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical