Provider Demographics
NPI:1396142147
Name:MASSE, JANICE LEE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:LEE
Last Name:MASSE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 N GREENWOOD LN
Mailing Address - Street 2:UNIT 2165
Mailing Address - City:ATHENS
Mailing Address - State:NY
Mailing Address - Zip Code:12015-2709
Mailing Address - Country:US
Mailing Address - Phone:518-965-2009
Mailing Address - Fax:
Practice Address - Street 1:20 N GREEENWOOD
Practice Address - Street 2:UNIT 2165
Practice Address - City:ATHENS
Practice Address - State:NY
Practice Address - Zip Code:12015
Practice Address - Country:US
Practice Address - Phone:518-965-2009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-21
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY730842091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical