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General NPI Number Information
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NPI Number | 1225763709
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Entity Type | Organization
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Legal Business Name | JANUS PSYCHOLOGICAL SERVICES, PLLC
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Dates
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Enumeration Date | 07/19/2022
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Last Update Date | 10/16/2025
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Provider Practice Location Address
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Address Line | 211 W 56TH ST APT 5J
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City | NEW YORK
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State | NY
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Zip | 10019-4316
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Country | US
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Telephone | 512-815-3814
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Fax |
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Provider Business Mailing Address
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Address Line | 211 W 56TH ST APT 5J
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City | NEW YORK
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State | NY
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Zip | 10019-4316
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Country | US
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Telephone | 512-815-3814
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Fax | 512-229-9176
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | ANNELISA PEDERSEN
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Credential | PHD
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Telephone | 512-815-3814
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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