Provider Demographics
NPI:1558431817
Name:MOORMAN, JANET D (LMFT)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:D
Last Name:MOORMAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:D
Other - Last Name:DORTMUND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:431 WEST 9TH STREET
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46016-1317
Mailing Address - Country:US
Mailing Address - Phone:765-649-2234
Mailing Address - Fax:765-640-0538
Practice Address - Street 1:431 WEST 9TH STREET
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46016-1317
Practice Address - Country:US
Practice Address - Phone:765-649-2234
Practice Address - Fax:765-640-0538
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35000212A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist