Provider Demographics
NPI:1093810400
Name:WOODCOCK, JANET LYNN (MSW LMSW ACSW)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:LYNN
Last Name:WOODCOCK
Suffix:
Gender:F
Credentials:MSW LMSW ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 E WALKER STREET
Mailing Address - Street 2:SUITE B
Mailing Address - City:ST JOHNS
Mailing Address - State:MI
Mailing Address - Zip Code:48879
Mailing Address - Country:US
Mailing Address - Phone:989-227-9000
Mailing Address - Fax:989-224-0058
Practice Address - Street 1:120 E WALKER STREET
Practice Address - Street 2:ST JOHNS COUNSELING & THERAPY SERVICES PC SUITE B
Practice Address - City:ST JOHNS
Practice Address - State:MI
Practice Address - Zip Code:48879
Practice Address - Country:US
Practice Address - Phone:989-227-9000
Practice Address - Fax:989-224-0058
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010341771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
7014234OtherAETNA
1002205OtherMCLAREN
108548OtherBLUE CARE NETWORK
8008971270OtherBLUE CROSS BLUE SHIELD
7014234OtherAETNA