Provider Demographics
NPI:1104837277
Name:LEBRON, JANICE (LPC, NCC)
Entity Type:Individual
Prefix:MISS
First Name:JANICE
Middle Name:
Last Name:LEBRON
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2685
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23609-0685
Mailing Address - Country:US
Mailing Address - Phone:757-508-5917
Mailing Address - Fax:240-526-3074
Practice Address - Street 1:2017 CUNNINGHAM DR STE 205
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-3315
Practice Address - Country:US
Practice Address - Phone:757-508-5917
Practice Address - Fax:240-526-5917
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003818101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health