Provider Demographics
NPI:1194308122
Name:JANHUNEN, STEPHANIE (LAC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:JANHUNEN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 W PARK ST
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-1714
Mailing Address - Country:US
Mailing Address - Phone:406-565-5484
Mailing Address - Fax:406-565-5485
Practice Address - Street 1:22 W PARK ST
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-1714
Practice Address - Country:US
Practice Address - Phone:406-565-5484
Practice Address - Fax:406-565-5485
Is Sole Proprietor?:No
Enumeration Date:2021-04-28
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LAC-LIC-54981101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)