Provider Demographics
NPI:1659153740
Name:CARLILE, JANEE MARIE
Entity Type:Individual
Prefix:
First Name:JANEE
Middle Name:MARIE
Last Name:CARLILE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12040 TRANQUILITY LN
Mailing Address - Street 2:
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-1338
Mailing Address - Country:US
Mailing Address - Phone:574-360-2695
Mailing Address - Fax:
Practice Address - Street 1:1415 LINCOLNWAY W
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:IN
Practice Address - Zip Code:46561-2062
Practice Address - Country:US
Practice Address - Phone:574-651-8912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health