Provider Demographics
NPI:1598443541
Name:EDDY, JANET MARIE (LPC)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:MARIE
Last Name:EDDY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1513 UNION AVE STE 2500
Mailing Address - Street 2:
Mailing Address - City:MOBERLY
Mailing Address - State:MO
Mailing Address - Zip Code:65270-9412
Mailing Address - Country:US
Mailing Address - Phone:660-372-1313
Mailing Address - Fax:660-372-1339
Practice Address - Street 1:1513 UNION AVE STE 2500
Practice Address - Street 2:
Practice Address - City:MOBERLY
Practice Address - State:MO
Practice Address - Zip Code:65270-9412
Practice Address - Country:US
Practice Address - Phone:660-372-1313
Practice Address - Fax:660-372-1339
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015005790101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional