Provider Demographics
NPI:1720141773
Name:TREECE, JANET K (MS LCPC)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:K
Last Name:TREECE
Suffix:
Gender:F
Credentials:MS LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 TIPPY RD
Mailing Address - Street 2:
Mailing Address - City:CARTERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62918-1560
Mailing Address - Country:US
Mailing Address - Phone:618-985-3406
Mailing Address - Fax:618-985-3406
Practice Address - Street 1:106 TIPPY RD
Practice Address - Street 2:
Practice Address - City:CARTERVILLE
Practice Address - State:IL
Practice Address - Zip Code:62918-1560
Practice Address - Country:US
Practice Address - Phone:618-985-3406
Practice Address - Fax:618-985-3406
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180001356101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health