Provider Demographics
NPI:1629613153
Name:SUMMERS, JANEECE MARIE (RESIDENT COUNSELOR)
Entity Type:Individual
Prefix:
First Name:JANEECE
Middle Name:MARIE
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:RESIDENT COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4219 YANCEYVILLE RD APT S
Mailing Address - Street 2:
Mailing Address - City:BROWNS SUMMIT
Mailing Address - State:NC
Mailing Address - Zip Code:27214-8903
Mailing Address - Country:US
Mailing Address - Phone:910-508-6473
Mailing Address - Fax:
Practice Address - Street 1:709 RIVER RIDGE RD
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-8303
Practice Address - Country:US
Practice Address - Phone:434-728-0794
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-07
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health