Provider Demographics
NPI:1649492471
Name:COUCH, JANET B (MA)
Entity type:Individual
Prefix:MS
First Name:JANET
Middle Name:B
Last Name:COUCH
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 1:128 E WATER ST
Mailing Address - Street 2:
Mailing Address - City:SAULT SAINTE MARIE
Mailing Address - State:MI
Mailing Address - Zip Code:49783-2052
Mailing Address - Country:US
Mailing Address - Phone:906-632-9174
Mailing Address - Fax:
Practice Address - Street 1:517 W EASTERDAY AVE
Practice Address - Street 2:
Practice Address - City:SAULT SAINTE MARIE
Practice Address - State:MI
Practice Address - Zip Code:49783-1623
Practice Address - Country:US
Practice Address - Phone:906-635-1508
Practice Address - Fax:906-635-7369
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802084903101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health