Provider Demographics
NPI:1225690795
Name:JANIEC, JAIME (LPC)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:JANIEC
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1545 KINGSWAY CT STE 207
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48183-1934
Mailing Address - Country:US
Mailing Address - Phone:313-213-6193
Mailing Address - Fax:
Practice Address - Street 1:1545 KINGSWAY CT STE 207
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:MI
Practice Address - Zip Code:48183-1934
Practice Address - Country:US
Practice Address - Phone:734-307-0318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-03
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401019657101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional