Provider Demographics
NPI:1033240700
Name:BINFORD, JANNA C (LPC)
Entity Type:Individual
Prefix:
First Name:JANNA
Middle Name:C
Last Name:BINFORD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 WILLOWOOD ST
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75604-3143
Mailing Address - Country:US
Mailing Address - Phone:903-806-5440
Mailing Address - Fax:
Practice Address - Street 1:708 WILLOWOOD ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75604-3143
Practice Address - Country:US
Practice Address - Phone:903-806-5440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61323101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX183818702Medicaid
TX183818701Medicaid
TX85286LOtherBLUE CROSS BLUE SHIELD