Provider Demographics
NPI:1811066772
Name:STANDISH, JANINE M (MA EDS LPC)
Entity type:Individual
Prefix:MS
First Name:JANINE
Middle Name:M
Last Name:STANDISH
Suffix:
Gender:F
Credentials:MA EDS LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 GODWIN AVE STE 230
Mailing Address - Street 2:
Mailing Address - City:MIDLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07432-1460
Mailing Address - Country:US
Mailing Address - Phone:973-896-7274
Mailing Address - Fax:
Practice Address - Street 1:700 GODWIN AVE STE 230
Practice Address - Street 2:
Practice Address - City:MIDLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07432-1460
Practice Address - Country:US
Practice Address - Phone:973-896-7274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00332900101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional