Healthcare Provider Details

I. General information

NPI: 1275675274
Provider Name (Legal Business Name): JANICE M. WOJAK MA LMHC LCPC NCC CAP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 11/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4550 ORANGE BLVD
SANFORD FL
32771-9108
US

IV. Provider business mailing address

4550 ORANGE BLVD
SANFORD FL
32771-9108
US

V. Phone/Fax

Practice location:
  • Phone: 800-614-4124
  • Fax:
Mailing address:
  • Phone: 800-614-4124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number180003448
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH13968
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: