Provider Demographics
NPI:1962668962
Name:BODET, JANICE BACINO (MED, LPC)
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:BACINO
Last Name:BODET
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 5TH ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-1865
Mailing Address - Country:US
Mailing Address - Phone:504-837-0607
Mailing Address - Fax:504-832-4040
Practice Address - Street 1:3001 5TH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-1865
Practice Address - Country:US
Practice Address - Phone:504-837-0607
Practice Address - Fax:504-832-4040
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA719101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health