Provider Demographics
NPI:1699828665
Name:STOREY, JANICE MARIE (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:MARIE
Last Name:STOREY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MRS
Other - First Name:JANICE
Other - Middle Name:MARIE
Other - Last Name:STOREY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:20307 VIKING AVE NW STE 203
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-8321
Mailing Address - Country:US
Mailing Address - Phone:360-697-1445
Mailing Address - Fax:360-307-0985
Practice Address - Street 1:20307 VIKING AVE NW STE 203
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-8321
Practice Address - Country:US
Practice Address - Phone:360-697-1445
Practice Address - Fax:360-307-0985
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00004200101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health