Provider Demographics
NPI:1194883751
Name:BAHARIS, JANIS (LPCC)
Entity type:Individual
Prefix:
First Name:JANIS
Middle Name:
Last Name:BAHARIS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 MARMION AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44502-2323
Mailing Address - Country:US
Mailing Address - Phone:330-782-5664
Mailing Address - Fax:330-782-1614
Practice Address - Street 1:535 MARMION AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44502-2323
Practice Address - Country:US
Practice Address - Phone:330-782-5664
Practice Address - Fax:330-782-1614
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0000790101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0803312Medicaid
OH1363Medicare UPIN