Provider Demographics
NPI:1316177538
Name:JANSZ, HISHARA C (LMFT)
Entity type:Individual
Prefix:
First Name:HISHARA
Middle Name:C
Last Name:JANSZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:HISHARA
Other - Middle Name:C
Other - Last Name:GODAKANDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:11059 E BETHANY DR STE 200
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-2637
Mailing Address - Country:US
Mailing Address - Phone:303-617-2300
Mailing Address - Fax:
Practice Address - Street 1:1504 GALENA STREET
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80010
Practice Address - Country:US
Practice Address - Phone:303-617-2300
Practice Address - Fax:303-617-2365
Is Sole Proprietor?:No
Enumeration Date:2009-07-22
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10594106H00000X
TX201009106H00000X
COMFT.0001174106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO12750956OtherCAQH