Provider Demographics
NPI:1275547663
Name:PICKARD, JANICE LYNN (LMHC)
Entity Type:Individual
Prefix:MS
First Name:JANICE
Middle Name:LYNN
Last Name:PICKARD
Suffix:
Gender:F
Credentials:LMHC
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 1675
Mailing Address - Street 2:
Mailing Address - City:COUPEVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98239-9741
Mailing Address - Country:US
Mailing Address - Phone:360-678-8800
Mailing Address - Fax:360-678-2254
Practice Address - Street 1:1075B BURCHELL ROAD
Practice Address - Street 2:
Practice Address - City:COUPEVILLE
Practice Address - State:WA
Practice Address - Zip Code:98239-9741
Practice Address - Country:US
Practice Address - Phone:360-678-8800
Practice Address - Fax:360-678-2254
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00004299101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor