Provider Demographics
NPI:1700889565
Name:TODD, JANET MEREDITH (LPC LMFT)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:MEREDITH
Last Name:TODD
Suffix:
Gender:F
Credentials:LPC LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 531
Mailing Address - Street 2:
Mailing Address - City:MEADOWVIEW
Mailing Address - State:VA
Mailing Address - Zip Code:24361-0531
Mailing Address - Country:US
Mailing Address - Phone:276-783-2440
Mailing Address - Fax:276-783-2021
Practice Address - Street 1:1258 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:VA
Practice Address - Zip Code:24354-4312
Practice Address - Country:US
Practice Address - Phone:276-783-2440
Practice Address - Fax:276-783-2021
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002753101YP2500X
VA0717001010106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA568156000OtherMAGELLAN MIS #
VA005407885Medicaid
VA342504OtherMHN PIN
VA394595OtherBC BS PIN
VA507638OtherVALUE OPTIONS PIN