Provider Demographics
NPI:1023259496
Name:MORENCY, JANET MARGARET (MA)
Entity type:Individual
Prefix:MS
First Name:JANET
Middle Name:MARGARET
Last Name:MORENCY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:745 S GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-5500
Mailing Address - Country:US
Mailing Address - Phone:231-947-5640
Mailing Address - Fax:231-947-0699
Practice Address - Street 1:745 S GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-5500
Practice Address - Country:US
Practice Address - Phone:231-947-5640
Practice Address - Fax:231-947-0699
Is Sole Proprietor?:No
Enumeration Date:2009-03-16
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000531231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0B10029OtherBLUE CROSS BLUE SHIELD OF MICHIGAN
MI0B10029OtherBLUE CROSS BLUE SHIELD OF MICHIGAN
MIP00939230Medicare PIN