Provider Demographics
NPI:1215681366
Name:JANES, NATASHA (LMFT)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:JANES
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7825 WOLF PEN BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:KY
Mailing Address - Zip Code:40059-9631
Mailing Address - Country:US
Mailing Address - Phone:502-939-2207
Mailing Address - Fax:
Practice Address - Street 1:7825 WOLF PEN BRANCH RD
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:KY
Practice Address - Zip Code:40059-9631
Practice Address - Country:US
Practice Address - Phone:502-939-2207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35002199A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist