Provider Demographics
NPI:1295568665
Name:STEVENS, JANELLE MARIE (LPC)
Entity type:Individual
Prefix:
First Name:JANELLE
Middle Name:MARIE
Last Name:STEVENS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1760 OLD TIOGA TPKE
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:PA
Mailing Address - Zip Code:17878-9200
Mailing Address - Country:US
Mailing Address - Phone:570-394-8854
Mailing Address - Fax:570-300-2629
Practice Address - Street 1:363R MARKET ST
Practice Address - Street 2:
Practice Address - City:BERWICK
Practice Address - State:PA
Practice Address - Zip Code:18603-3717
Practice Address - Country:US
Practice Address - Phone:570-759-2820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC017511101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional