Provider Demographics
NPI:1407949670
Name:KAY, JANICE HOPE (LPA)
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:HOPE
Last Name:KAY
Suffix:
Gender:F
Credentials:LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 FRIAR TUCK RD
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28625-9057
Mailing Address - Country:US
Mailing Address - Phone:704-876-2229
Mailing Address - Fax:
Practice Address - Street 1:114 FRIAR TUCK RD
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28625-9057
Practice Address - Country:US
Practice Address - Phone:704-876-2229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1332103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6107124Medicaid