Individual
JANE C PEDERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1075 MAIN AVE, SUITE 214, DURANGO, CO 81301-5369
(970) 385-5266
(615) 296-2773
Mailing address
1075 MAIN AVE, SUITE 214, DURANGO, CO 81301-5369
(970) 385-5266
(615) 296-2773
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
4607
IL
101YM0800X
Mental Health Counselor
Primary
560
CO
101YM0800X
Mental Health Counselor
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
560
LICCLINICALSOCIALWORKER
CO
Enumeration date
08/29/2006
Last updated
11/18/2007
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