Healthcare Provider Details

I. General information

NPI: 1366891756
Provider Name (Legal Business Name): JANENE GORSETT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANENE GORSETT LMHC

II. Dates (important events)

Enumeration Date: 06/07/2016
Last Update Date: 04/15/2024
Certification Date: 04/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3650 GLEN OAKS BLVD
SIOUX CITY IA
51104-1546
US

IV. Provider business mailing address

125 E JACKSON ST
SMITHLAND IA
51056-8637
US

V. Phone/Fax

Practice location:
  • Phone: 712-222-1459
  • Fax:
Mailing address:
  • Phone: 712-256-7888
  • Fax: 712-256-6502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number083013
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2144
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: