Provider Demographics
NPI:1770717621
Name:STEVENS, JANICE RENE' (LCPC)
Entity type:Individual
Prefix:MS
First Name:JANICE
Middle Name:RENE'
Last Name:STEVENS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 W SUPERIOR ST STE C
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-1684
Mailing Address - Country:US
Mailing Address - Phone:208-263-5551
Mailing Address - Fax:208-255-4476
Practice Address - Street 1:710 W SUPERIOR ST STE C
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-1684
Practice Address - Country:US
Practice Address - Phone:208-263-5551
Practice Address - Fax:208-255-4476
Is Sole Proprietor?:No
Enumeration Date:2009-05-06
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101Y00000XBehavioral Health & Social Service ProvidersCounselor