Provider Demographics
NPI:1497903033
Name:HANCOCK, JANICE L (LMFT)
Entity Type:Individual
Prefix:MS
First Name:JANICE
Middle Name:L
Last Name:HANCOCK
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 NE 4TH ST
Mailing Address - Street 2:
Mailing Address - City:HERMISTON
Mailing Address - State:OR
Mailing Address - Zip Code:97838-1816
Mailing Address - Country:US
Mailing Address - Phone:541-490-5790
Mailing Address - Fax:541-896-4081
Practice Address - Street 1:410 NE 4TH ST
Practice Address - Street 2:
Practice Address - City:HERMISTON
Practice Address - State:OR
Practice Address - Zip Code:97838-1816
Practice Address - Country:US
Practice Address - Phone:541-490-5790
Practice Address - Fax:541-896-4081
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-08
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 46913106H00000X
ORT0720106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR13678064OtherCAQH