Provider Demographics
NPI:1699853952
Name:HAVER, JANINE A (LCSW)
Entity Type:Individual
Prefix:
First Name:JANINE
Middle Name:A
Last Name:HAVER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JANINE
Other - Middle Name:A
Other - Last Name:SECH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 304
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:NY
Mailing Address - Zip Code:13619
Mailing Address - Country:US
Mailing Address - Phone:315-376-5450
Mailing Address - Fax:315-376-7221
Practice Address - Street 1:5440 TRINITY AVE
Practice Address - Street 2:
Practice Address - City:LOWVILLE
Practice Address - State:NY
Practice Address - Zip Code:13367
Practice Address - Country:US
Practice Address - Phone:315-376-4676
Practice Address - Fax:315-376-4676
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0753041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical