Healthcare Provider Details

I. General information

NPI: 1780671701
Provider Name (Legal Business Name): JOSEPH A. JANOCKA LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 W CRISER RD SUITE 100
FRONT ROYAL VA
22630-2360
US

IV. Provider business mailing address

209 W CRISER RD SUITE 100
FRONT ROYAL VA
22630-2360
US

V. Phone/Fax

Practice location:
  • Phone: 540-636-2931
  • Fax: 540-636-2933
Mailing address:
  • Phone: 540-636-2931
  • Fax: 540-636-2933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701003842
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: