Provider Demographics
NPI:1386810844
Name:BOGARD, JANET L (LCSW)
Entity type:Individual
Prefix:MS
First Name:JANET
Middle Name:L
Last Name:BOGARD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1363 W SPRUCE AVE
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-5327
Mailing Address - Country:US
Mailing Address - Phone:907-376-2411
Mailing Address - Fax:907-376-3363
Practice Address - Street 1:3261 S BIG LAKE RD
Practice Address - Street 2:
Practice Address - City:BIG LAKE
Practice Address - State:AK
Practice Address - Zip Code:99623-9663
Practice Address - Country:US
Practice Address - Phone:907-376-2411
Practice Address - Fax:907-352-3363
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-05
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK13141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical