MEDICARE: MRS. DONNA G JANIEC LPCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1013485135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DONNA G JANIEC LPCC

Provider Business Mailing Address
First Line	:	3490 CEDARHURST WAY
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-4828
Country	:	US
Telephone Number	:	719-639-2650
Fax Number	:

Provider Business Practice Location Address
First Line	:	6285 LEHMAN DR STE 206
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-1498
Country	:	US
Telephone Number	:	719-639-2650
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2018
Last Update Date	:	11/06/2018

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