Provider Demographics
NPI:1447428206
Name:CARPENTIER, JANET M (LISAC)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:M
Last Name:CARPENTIER
Suffix:
Gender:F
Credentials:LISAC
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 38
Mailing Address - Street 2:NEW BEGINNINGS BLDG
Mailing Address - City:SACATON
Mailing Address - State:AZ
Mailing Address - Zip Code:85247
Mailing Address - Country:US
Mailing Address - Phone:602-350-0153
Mailing Address - Fax:480-219-8262
Practice Address - Street 1:483 W SEEDFARM ROAD
Practice Address - Street 2:NEW BEGINNINGS BLDG
Practice Address - City:SACATON
Practice Address - State:AZ
Practice Address - Zip Code:85247
Practice Address - Country:US
Practice Address - Phone:602-350-0153
Practice Address - Fax:480-219-8262
Is Sole Proprietor?:No
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10475101YA0400X
MA2013101YA0400X
MA0762AL101YA0400X
AZ201801101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health