MEDICARE: DR. JANET A LEMMON PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	1066	CO
2	103G00000X	Clinical Neuropsychologist	1066	CO

General Provider Information

NPI Number	:	1831173384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANET A LEMMON PHD

Provider Business Mailing Address
First Line	:	PO BOX 928
Second Line	:
City	:	LAFAYETTE
State	:	CO
Zip	:	80026-0928
Country	:	US
Telephone Number	:	303-443-3557
Fax Number	:	303-386-4661

Provider Business Practice Location Address
First Line	:	1120 W SOUTH BOULDER RD STE 201D
Second Line	:
City	:	LAFAYETTE
State	:	CO
Zip	:	80026-8952
Country	:	US
Telephone Number	:	303-443-3557
Fax Number	:	303-386-4661

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2005
Last Update Date	:	09/22/2020

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