Provider Demographics
NPI:1215994124
Name:YELOWCHAN, JANET (LAC, LPC, LAC, LMHC)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:YELOWCHAN
Suffix:
Gender:F
Credentials:LAC, LPC, LAC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1623 MATHEWS ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-1011
Mailing Address - Country:US
Mailing Address - Phone:970-494-1120
Mailing Address - Fax:
Practice Address - Street 1:1623 MATHEWS ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-1011
Practice Address - Country:US
Practice Address - Phone:970-494-1120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO91101YA0400X
OR6661101YP2500X
WALH61250395101YM0800X
NMCCMH0223511101YP2500X
TX93079101YP2500X
CO603171100000X
CO2461101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171100000XOther Service ProvidersAcupuncturist