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General NPI Number Information
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NPI Number | 1659838845
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Entity Type | Individual
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Provider Name | JANEL WITHERSPOON LPC
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Gender | Female
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Dates
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Enumeration Date | 02/25/2019
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Last Update Date | 07/05/2019
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Provider Practice Location Address
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Address Line | 34975 N NORTH VALLEY PKWY STE 152
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City | PHOENIX
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State | AZ
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Zip | 85086-4032
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Country | US
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Telephone | 623-688-9158
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Fax |
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Provider Business Mailing Address
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Address Line | 20118 N 67TH AVE STE 300-315
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City | GLENDALE
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State | AZ
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Zip | 85308-4621
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Country | US
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Telephone | 623-688-9158
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC-17633
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License Number State | AZ
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