| Jane L. Johnson, Llc | |
|
2627 Redwing Rd Ste 235 Fort Collins CO 80526-6352 | |
| (970) 266-2678 | |
| (970) 631-8873 |
| Full Name | Jane L. Johnson, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2627 Redwing Rd Ste 235, Fort Collins, Colorado |
| Authorized Official Name and Position | Jane Louise Johnson (OWNER) |
| Authorized Official Contact | 9702662678 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jane L. Johnson, Llc 2627 Redwing Rd Ste 235 Fort Collins CO 80526-6352 Ph: (970) 266-2678 | Jane L. Johnson, Llc 2627 Redwing Rd Ste 235 Fort Collins CO 80526-6352 Ph: (970) 266-2678 |
| NPI Number | 1952847444 |
|---|---|
| Provider Enumeration Date | 01/09/2017 |
| Last Update Date | 03/23/2022 |
| Certification Date | 03/22/2022 |
| Medicare PECOS PAC ID | 4789939109 |
|---|---|
| Medicare Enrollment ID | O20180626000907 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952847444 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 989157 (Colorado) | Primary |
| Provider Name | Jane L Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376582890 PECOS PAC ID: 5698020014 Enrollment ID: I20180626001103 |
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