Provider Demographics
NPI:1215041512
Name:JAYMIN, JANET JESSIE (MA, LPC, BLSW)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:JESSIE
Last Name:JAYMIN
Suffix:
Gender:F
Credentials:MA, LPC, BLSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2518 VILLAGE DR SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49506-5452
Mailing Address - Country:US
Mailing Address - Phone:616-264-0252
Mailing Address - Fax:
Practice Address - Street 1:8214 PFEIFFER FARMS DR SW
Practice Address - Street 2:
Practice Address - City:BYRON CENTER
Practice Address - State:MI
Practice Address - Zip Code:49315-8288
Practice Address - Country:US
Practice Address - Phone:616-235-5122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401008428101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health