Provider Demographics
NPI:1093574774
Name:JANET N STELLWAY
Entity Type:Organization
Organization Name:JANET N STELLWAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:STELLWAY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:208-467-9428
Mailing Address - Street 1:516 S IVY ST
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-5165
Mailing Address - Country:US
Mailing Address - Phone:208-467-9428
Mailing Address - Fax:
Practice Address - Street 1:1214 12TH AVE S
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-4665
Practice Address - Country:US
Practice Address - Phone:208-467-9428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty