Provider Demographics
NPI:1831644467
Name:VETTER, JANICE (LPC)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:VETTER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1044 NORTHWEST BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-2114
Mailing Address - Country:US
Mailing Address - Phone:208-667-7777
Mailing Address - Fax:208-667-7772
Practice Address - Street 1:1044 NORTHWEST BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2114
Practice Address - Country:US
Practice Address - Phone:208-667-7777
Practice Address - Fax:208-667-7772
Is Sole Proprietor?:No
Enumeration Date:2016-08-24
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-6306101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health