Healthcare Provider Details

I. General information

NPI: 1235516543
Provider Name (Legal Business Name): JANET EARLEY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2015
Last Update Date: 05/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6916 HIGHWAY 82
GLENWOOD SPRINGS CO
81601-9435
US

IV. Provider business mailing address

715 HORIZON DR SUITE 225
GRAND JUNCTION CO
81506
US

V. Phone/Fax

Practice location:
  • Phone: 970-945-2583
  • Fax: 970-928-8852
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW09924145
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0000001131
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: