Provider Demographics
NPI:1194326926
Name:BRYAN, JANAI JUNE (LCSW-S)
Entity type:Individual
Prefix:
First Name:JANAI
Middle Name:JUNE
Last Name:BRYAN
Suffix:
Gender:F
Credentials:LCSW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8900 COLBERG DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-4180
Mailing Address - Country:US
Mailing Address - Phone:650-454-6538
Mailing Address - Fax:
Practice Address - Street 1:2312 WESTERN TRAILS BLVD STE B204
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1677
Practice Address - Country:US
Practice Address - Phone:650-454-6538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX571551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical