Provider Demographics
NPI:1073806451
Name:MINTON, JANET DENISE (MSW, LCSWA)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:DENISE
Last Name:MINTON
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4330 COLLETTSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:COLLETTSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28611-9000
Mailing Address - Country:US
Mailing Address - Phone:803-898-4870
Mailing Address - Fax:803-898-0123
Practice Address - Street 1:4330 COLLETTSVILLE RD
Practice Address - Street 2:
Practice Address - City:COLLETTSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28611-9000
Practice Address - Country:US
Practice Address - Phone:828-754-2409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-18
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0111671041C0700X
NCC0125831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCC012583OtherNC BOARD OF SOCIAL WORK
NCP01167OtherNC BOARD OF SOCIAL WORK