Provider Demographics
NPI:1760465314
Name:ROLLINS-DEAN, JANICE EILEEN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:EILEEN
Last Name:ROLLINS-DEAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1145 JOANNA CT
Mailing Address - Street 2:
Mailing Address - City:MCKINLEYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95519-3947
Mailing Address - Country:US
Mailing Address - Phone:707-839-9566
Mailing Address - Fax:707-825-6753
Practice Address - Street 1:1600 WEEOT WAY
Practice Address - Street 2:
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-4734
Practice Address - Country:US
Practice Address - Phone:707-825-5060
Practice Address - Fax:707-825-6753
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 171981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical