Provider Demographics
NPI:1558880229
Name:CREECH, JANA LYNN (LCSW)
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:LYNN
Last Name:CREECH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 W RALPH HALL PKWY STE 105
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-8707
Mailing Address - Country:US
Mailing Address - Phone:972-772-8484
Mailing Address - Fax:469-698-8569
Practice Address - Street 1:935 W RALPH HALL PKWY STE 105
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-8707
Practice Address - Country:US
Practice Address - Phone:972-772-8484
Practice Address - Fax:469-698-8569
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX570551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical