Provider Demographics
NPI:1104019108
Name:GADDIS, JANET (MA)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:GADDIS
Suffix:
Gender:
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-4802
Mailing Address - Country:US
Mailing Address - Phone:501-203-0055
Mailing Address - Fax:501-203-0060
Practice Address - Street 1:2900 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4802
Practice Address - Country:US
Practice Address - Phone:501-203-0055
Practice Address - Fax:501-203-0060
Is Sole Proprietor?:No
Enumeration Date:2007-08-22
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP2004003101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional