Provider Demographics
NPI:1750650560
Name:DEAN, JANICE FAIN (LCPC, NCC)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:FAIN
Last Name:DEAN
Suffix:
Gender:F
Credentials:LCPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9727 GEORGIA AVENUE
Mailing Address - Street 2:WASHINGTON PASTORAL COUNSELING SERVICE
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910
Mailing Address - Country:US
Mailing Address - Phone:301-717-1131
Mailing Address - Fax:301-913-9447
Practice Address - Street 1:9727 GEORGIA AVENUE
Practice Address - Street 2:WASHINGTON PASTORAL COUNSELING SERVICE
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-1458
Practice Address - Country:US
Practice Address - Phone:301-717-1131
Practice Address - Fax:301-913-9447
Is Sole Proprietor?:No
Enumeration Date:2011-12-22
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3614101YM0800X, 101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral