Provider Demographics
NPI:1861687030
Name:VOLTMER, JANIS M (LCSW R)
Entity Type:Individual
Prefix:
First Name:JANIS
Middle Name:M
Last Name:VOLTMER
Suffix:
Gender:F
Credentials:LCSW R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 GRAPE HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:HOLMES
Mailing Address - State:NY
Mailing Address - Zip Code:12531
Mailing Address - Country:US
Mailing Address - Phone:845-750-9768
Mailing Address - Fax:
Practice Address - Street 1:56 JUNE RD
Practice Address - Street 2:
Practice Address - City:NORTH SALEM
Practice Address - State:NY
Practice Address - Zip Code:10560-1702
Practice Address - Country:US
Practice Address - Phone:845-750-9768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-11
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR 041494-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY10206403Medicaid
NYN79391Medicare UPIN