Basic Information
| Provider Information | |||||||||
| NPI: | 1235516543 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | EARLEY | ||||||||
| FirstName: | JANET | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 715 HORIZON DR | ||||||||
| Address2: | SUITE 225 | ||||||||
| City: | GRAND JUNCTION | ||||||||
| State: | CO | ||||||||
| PostalCode: | 81506 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 6916 HIGHWAY 82 | ||||||||
| Address2: | |||||||||
| City: | GLENWOOD SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 816019435 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9709452583 | ||||||||
| FaxNumber: | 9709288852 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/06/2015 | ||||||||
| LastUpdateDate: | 05/19/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | CSW09924145 | CO | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 101YM0800X | 0000001131 | CO | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.