Provider Demographics
NPI:1467401281
Name:BICE-ALLEN, JANYSE L (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:JANYSE
Middle Name:L
Last Name:BICE-ALLEN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 S ADAMS ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54301-4117
Mailing Address - Country:US
Mailing Address - Phone:920-884-5005
Mailing Address - Fax:920-884-1997
Practice Address - Street 1:425 S ADAMS ST
Practice Address - Street 2:SUITE 204
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-4117
Practice Address - Country:US
Practice Address - Phone:920-884-5005
Practice Address - Fax:920-884-1997
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2375-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical