Provider Demographics
NPI:1003827882
Name:STORM, JANET SUE (LCSW, LMFT)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:SUE
Last Name:STORM
Suffix:
Gender:F
Credentials:LCSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 47461
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46247-0461
Mailing Address - Country:US
Mailing Address - Phone:317-865-0183
Mailing Address - Fax:317-885-7137
Practice Address - Street 1:1602 W SMITH VALLEY RD # 6
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-1550
Practice Address - Country:US
Practice Address - Phone:317-865-0183
Practice Address - Fax:317-885-7137
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN340008231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN597410Medicare ID - Type UnspecifiedMEDICARE