Provider Demographics
NPI:1134745177
Name:EDDY, JANELLE LYNNE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JANELLE
Middle Name:LYNNE
Last Name:EDDY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-1624
Mailing Address - Country:US
Mailing Address - Phone:508-735-4373
Mailing Address - Fax:
Practice Address - Street 1:209 HIGH ST
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-1624
Practice Address - Country:US
Practice Address - Phone:508-735-4373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA225838104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker