Provider Demographics
NPI:1578693560
Name:MARRA, JANET MARIE (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:MARIE
Last Name:MARRA
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3701 E 13 MILE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48092-3795
Mailing Address - Country:US
Mailing Address - Phone:586-274-0200
Mailing Address - Fax:586-274-0228
Practice Address - Street 1:3701 E 13 MILE RD
Practice Address - Street 2:SUITE B
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48092-3795
Practice Address - Country:US
Practice Address - Phone:586-274-0200
Practice Address - Fax:586-274-0228
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI1550446101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6401006906OtherLICENSED PROFESSIONAL COUNSELOR