Provider Demographics
NPI:1851762843
Name:DOWDY, JANINA L (LCSW)
Entity Type:Individual
Prefix:
First Name:JANINA
Middle Name:L
Last Name:DOWDY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:NINA
Other - Middle Name:L
Other - Last Name:DOWDY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:2534 N COUNTRYSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:KUNA
Mailing Address - State:ID
Mailing Address - Zip Code:83634-2503
Mailing Address - Country:US
Mailing Address - Phone:208-891-2853
Mailing Address - Fax:208-891-2853
Practice Address - Street 1:1801 N LAKES PL STE 100
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83646-1906
Practice Address - Country:US
Practice Address - Phone:208-891-2853
Practice Address - Fax:208-891-2853
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-15
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID34859101YM0800X
IDLCSW-395941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health