Provider Demographics
NPI:1346650710
Name:JANE ST PIERRE
Entity Type:Organization
Organization Name:JANE ST PIERRE
Other - Org Name:HEALING ANGEL MINISTRIES
Other - Org Type:Other Name
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:ST. PIERRE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:520-429-3673
Mailing Address - Street 1:3115 N FAIRVIEW AVE
Mailing Address - Street 2:#146
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-3721
Mailing Address - Country:US
Mailing Address - Phone:520-429-3673
Mailing Address - Fax:
Practice Address - Street 1:3115 N FAIRVIEW AVE
Practice Address - Street 2:#146
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-3721
Practice Address - Country:US
Practice Address - Phone:520-429-3673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-06
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW 10827251S00000X
AZLCSW10827302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No302R00000XManaged Care OrganizationsHealth Maintenance Organization