Healthcare Provider Details

I. General information

NPI: 1235388364
Provider Name (Legal Business Name): JANE ANN LANDIS M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2008
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5808 S RAPP ST STE 104
LITTLETON CO
80120-1942
US

IV. Provider business mailing address

5808 S RAPP ST STE 104
LITTLETON CO
80120-1942
US

V. Phone/Fax

Practice location:
  • Phone: 720-819-7799
  • Fax:
Mailing address:
  • Phone: 720-819-7799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0016972
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: