Healthcare Provider Details

I. General information

NPI: 1437395175
Provider Name (Legal Business Name): JANAE KIMBERLY WOJASINSKI LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANAE KIMBERLY LYONS LPC

II. Dates (important events)

Enumeration Date: 12/31/2008
Last Update Date: 08/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2214 N PECAN ST
NACOGDOCHES TX
75965-3502
US

IV. Provider business mailing address

2214 N PECAN ST
NACOGDOCHES TX
75965-3502
US

V. Phone/Fax

Practice location:
  • Phone: 936-560-6855
  • Fax: 936-564-5232
Mailing address:
  • Phone: 936-560-6855
  • Fax: 936-564-5232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4361
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number66495
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: