Provider Demographics
NPI:1477726040
Name:VINCENT, JANET KAY (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:KAY
Last Name:VINCENT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28641 LATHRUP BLVD
Mailing Address - Street 2:
Mailing Address - City:LATHRUP VILLAGE
Mailing Address - State:MI
Mailing Address - Zip Code:48076-2849
Mailing Address - Country:US
Mailing Address - Phone:248-752-9160
Mailing Address - Fax:
Practice Address - Street 1:30500 VAN DYKE AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-2195
Practice Address - Country:US
Practice Address - Phone:248-752-9160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-03
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401008417101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional