Provider Demographics
NPI:1629843271
Name:JANICKI, JAMIE HELEN (LPC, MAC)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:HELEN
Last Name:JANICKI
Suffix:
Gender:F
Credentials:LPC, MAC
Other - Prefix:
Other - First Name:JAY
Other - Middle Name:
Other - Last Name:JANICKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC, MAC
Mailing Address - Street 1:524 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-1216
Mailing Address - Country:US
Mailing Address - Phone:215-527-8012
Mailing Address - Fax:
Practice Address - Street 1:524 W BROAD ST
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-1216
Practice Address - Country:US
Practice Address - Phone:215-527-8012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-22
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC016440101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty