Basic Information
Provider Information
NPI: 1245492347
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VOELLER
FirstName: JANELLE
MiddleName: MARIE
NamePrefix: MRS.
NameSuffix:  
Credential: LICSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 5074
Address2:  
City: SIOUX FALLS
State: SD
PostalCode: 571175074
CountryCode: US
TelephoneNumber: 6053286585
FaxNumber:  
Practice Location
Address1: 414 N 7TH ST
Address2:  
City: BISMARCK
State: ND
PostalCode: 585014423
CountryCode: US
TelephoneNumber: 7013236543
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/30/2008
LastUpdateDate: 10/21/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000X4048NDN Behavioral Health & Social Service ProvidersSocial Worker 
1041C0700X4048NDY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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