Provider Demographics
NPI:1396234035
Name:JAMES, JANICE KAY
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:KAY
Last Name:JAMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40588-0006
Mailing Address - Country:US
Mailing Address - Phone:859-252-2002
Mailing Address - Fax:859-252-2002
Practice Address - Street 1:1524 VERSAILLES RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-2406
Practice Address - Country:US
Practice Address - Phone:859-252-2002
Practice Address - Fax:859-252-2592
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-08
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY6441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical