Individual
JANELLE I. DIRSTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
7050 W 120TH AVE UNIT 120, BROOMFIELD, CO 80020-7604
(303) 587-1296
Mailing address
7050 W 120TH AVE UNIT 120, BROOMFIELD, CO 80020-7604
(303) 587-1296
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5945
—
320800000X
Mental Illness Community Based Residential Treatment Facility
5945
CO
Other
Enumeration date
07/05/2012
Last updated
11/09/2023
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