Provider Demographics
NPI:1487708491
Name:INFANT, JANICE ELAINE (LPCC, LSP)
Entity type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:ELAINE
Last Name:INFANT
Suffix:
Gender:F
Credentials:LPCC, LSP
Other - Prefix:MRS
Other - First Name:JANICE
Other - Middle Name:ELAINE
Other - Last Name:BRACACCIO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPCC, LSP
Mailing Address - Street 1:3843 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-4718
Mailing Address - Country:US
Mailing Address - Phone:330-372-2200
Mailing Address - Fax:330-372-2600
Practice Address - Street 1:3843 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-4718
Practice Address - Country:US
Practice Address - Phone:330-372-2200
Practice Address - Fax:330-372-2600
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE 0005879101YP2500X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist