Individual
JANELLE MARIE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, CSAC
Contact information
Practice address
1717 TAYLOR AVE, RACINE, WI 53403-2405
(262) 638-6744
(262) 638-6540
Mailing address
1717 TAYLOR AVE, RACINE, WI 53403-2405
(262) 638-6744
(262) 638-6540
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16289-132
WI
1041C0700X
Clinical Social Worker
Primary
8838-123
WI
Other
Enumeration date
10/21/2012
Last updated
07/03/2019
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