Provider Demographics
NPI:1760555841
Name:TREECE, JOANN R (MS, LMHC)
Entity Type:Individual
Prefix:
First Name:JOANN
Middle Name:R
Last Name:TREECE
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 E MAIN ST
Mailing Address - Street 2:PO BOX 34
Mailing Address - City:BOSWELL
Mailing Address - State:IN
Mailing Address - Zip Code:47921-8037
Mailing Address - Country:US
Mailing Address - Phone:765-404-4764
Mailing Address - Fax:
Practice Address - Street 1:225 N 4TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47901-1172
Practice Address - Country:US
Practice Address - Phone:765-404-4764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39000412A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health