Provider Demographics
NPI:1760718027
Name:BANAS, JANE ANN (LPC)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:ANN
Last Name:BANAS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:71 WALNUT BLVD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-2073
Mailing Address - Country:US
Mailing Address - Phone:248-650-3795
Mailing Address - Fax:248-650-2293
Practice Address - Street 1:71 WALNUT BLVD
Practice Address - Street 2:SUITE 207
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-2073
Practice Address - Country:US
Practice Address - Phone:248-650-3795
Practice Address - Fax:248-650-2293
Is Sole Proprietor?:No
Enumeration Date:2009-10-21
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI6401006739101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional