Provider Demographics
NPI:1952660938
Name:DEBLAUWE, JANIE MADONNA (LMHC, RN)
Entity Type:Individual
Prefix:MRS
First Name:JANIE MADONNA
Middle Name:
Last Name:DEBLAUWE
Suffix:
Gender:F
Credentials:LMHC, RN
Other - Prefix:
Other - First Name:MADONNA
Other - Middle Name:
Other - Last Name:DEBLAUWE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC, RN
Mailing Address - Street 1:4648 SE SALVATORI RD
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-8271
Mailing Address - Country:US
Mailing Address - Phone:941-526-5133
Mailing Address - Fax:
Practice Address - Street 1:4648 SE SALVATORI RD
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-8271
Practice Address - Country:US
Practice Address - Phone:941-526-5133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-10
Last Update Date:2024-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9425217163W00000X
FLMH11837101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No163W00000XNursing Service ProvidersRegistered Nurse