Warner, Jan Earl

Warner, Jan Earl is an individual health care provider with primary practice located at 230 E Day Rd Ste 160 , Mishawaka IN 46545-3463. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Cognitive & Behavioral, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Warner, Jan Earl can be contacted via phone (574) 271-8222.

Contact Information

Primary practice address
230 E Day Rd Ste 160 Mishawaka IN 46545-3463
Phone: (574) 271-8222
Fax: (574) 271-8896
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X IN20040740 Indiana
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 20040740A Indiana
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X 20040740A Indiana
Behavioral Health & Social Service Providers / Clinical 103TC0700X 20040740A Indiana

Profile Details

NPI number 1043214679
LBN Legal business name Warner, Jan Earl
Credentials PHD HSPP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2005
Last updated Sep 3rd, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043214679 NPPES
Indiana MEDICAID 100383350A
Indiana Other 000000196536

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