Provider Demographics
NPI:1053503839
Name:HAY, JANET ELIZABETH (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:ELIZABETH
Last Name:HAY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:MRS
Other - First Name:JANET
Other - Middle Name:ELIZABETH
Other - Last Name:HAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCPC
Mailing Address - Street 1:3701 E LAKE CTR
Mailing Address - Street 2:SUITE 7
Mailing Address - City:QUINCY
Mailing Address - State:IL
Mailing Address - Zip Code:62305-5842
Mailing Address - Country:US
Mailing Address - Phone:217-653-5454
Mailing Address - Fax:217-221-9398
Practice Address - Street 1:3701 E LAKE CTR
Practice Address - Street 2:SUITE 7
Practice Address - City:QUINCY
Practice Address - State:IL
Practice Address - Zip Code:62305-5842
Practice Address - Country:US
Practice Address - Phone:217-653-5454
Practice Address - Fax:217-221-9398
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180005333101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL11537510OtherCAQH
IL0000132022OtherBLUE CROSS BLUE SHIELD