Provider Demographics
NPI:1164841284
Name:JANICE C. C. LEPORE, PSY.D., AND ASSOCIATES, LLC
Entity Type:Organization
Organization Name:JANICE C. C. LEPORE, PSY.D., AND ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST/AUTHORIZED ME
Authorized Official - Prefix:DR
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:C C
Authorized Official - Last Name:LEPORE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:443-912-1230
Mailing Address - Street 1:1400 FRONT AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-5300
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1400 FRONT AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-5300
Practice Address - Country:US
Practice Address - Phone:443-912-1230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-16
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD4196103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1629108022OtherNPI FOR JANICE LEPORE