Provider Demographics
NPI:1558747287
Name:VANSCOYK, JANET RUTH (LMSW)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:RUTH
Last Name:VANSCOYK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:RUTH
Other - Last Name:SHAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1982 W ISLAND CIR
Mailing Address - Street 2:
Mailing Address - City:SAFFORD
Mailing Address - State:AZ
Mailing Address - Zip Code:85546-4049
Mailing Address - Country:US
Mailing Address - Phone:307-760-5866
Mailing Address - Fax:
Practice Address - Street 1:1982 W ISLAND CIR
Practice Address - Street 2:
Practice Address - City:SAFFORD
Practice Address - State:AZ
Practice Address - Zip Code:85546-4049
Practice Address - Country:US
Practice Address - Phone:307-760-5866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-04
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
AZLMSW-16336104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZLMSW-16336OtherAZ BOARD OF BEHAVIORAL HEALTH