Individual
JANELLE WAGENKNECHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPCC, ADDC
Contact information
Practice address
8059 RADCLIFF DR, COLORADO SPRINGS, CO 80920-8060
(719) 332-4102
Mailing address
8059 RADCLIFF DR, COLORADO SPRINGS, CO 80920-8060
(719) 332-4102
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
ADDC.0000435
CO
101YP2500X
Professional Counselor
Primary
LPCC.0021476
CO
Other
Enumeration date
09/14/2024
Last updated
09/14/2024
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