Provider Demographics
NPI:1437870755
Name:HUSTED, JANEANE ALLISON (CDCA)
Entity Type:Individual
Prefix:
First Name:JANEANE
Middle Name:ALLISON
Last Name:HUSTED
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5243 COLUMBUS SANDUSKY RD N
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-9009
Mailing Address - Country:US
Mailing Address - Phone:740-914-0058
Mailing Address - Fax:
Practice Address - Street 1:1581 MARION WALDO RD UNIT 710
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-7423
Practice Address - Country:US
Practice Address - Phone:740-251-4175
Practice Address - Fax:740-751-6861
Is Sole Proprietor?:No
Enumeration Date:2022-09-06
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.184578101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)