Provider Demographics
NPI:1548641384
Name:HOUSTON, JANICE JENNICE (LMSW)
Entity type:Individual
Prefix:MS
First Name:JANICE
Middle Name:JENNICE
Last Name:HOUSTON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 751
Mailing Address - Street 2:
Mailing Address - City:BROOKPORT
Mailing Address - State:IL
Mailing Address - Zip Code:62910
Mailing Address - Country:US
Mailing Address - Phone:618-602-8907
Mailing Address - Fax:
Practice Address - Street 1:818 PARKVIEW LANE
Practice Address - Street 2:APT A
Practice Address - City:METROPOLIS
Practice Address - State:IL
Practice Address - Zip Code:62960
Practice Address - Country:US
Practice Address - Phone:618-602-8907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-17
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker