Provider Demographics
NPI:1568221661
Name:JANES, TRICIA (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:TRICIA
Middle Name:
Last Name:JANES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 GEORGES DR
Mailing Address - Street 2:
Mailing Address - City:ATTICA
Mailing Address - State:NY
Mailing Address - Zip Code:14011-1214
Mailing Address - Country:US
Mailing Address - Phone:585-297-8375
Mailing Address - Fax:
Practice Address - Street 1:63 GEORGES DR
Practice Address - Street 2:
Practice Address - City:ATTICA
Practice Address - State:NY
Practice Address - Zip Code:14011-1214
Practice Address - Country:US
Practice Address - Phone:585-297-8375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0599961041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool