Provider Demographics
NPI:1588847149
Name:HAVARD, JANINE (LPC)
Entity Type:Individual
Prefix:
First Name:JANINE
Middle Name:
Last Name:HAVARD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:JANINE
Other - Middle Name:
Other - Last Name:AWTREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:402 PAINT BRUSH CIR
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-5345
Mailing Address - Country:US
Mailing Address - Phone:409-489-1100
Mailing Address - Fax:936-634-7631
Practice Address - Street 1:315 W HOUSTON ST
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:TX
Practice Address - Zip Code:75951-4013
Practice Address - Country:US
Practice Address - Phone:409-489-1100
Practice Address - Fax:936-634-7631
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-06
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18076101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health