Provider Demographics
NPI:1538387816
Name:MILLER-DELANY, JANINE LOUISE (MA, LPCC)
Entity type:Individual
Prefix:MRS
First Name:JANINE
Middle Name:LOUISE
Last Name:MILLER-DELANY
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:UPPER SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:43351-9018
Mailing Address - Country:US
Mailing Address - Phone:419-294-8596
Mailing Address - Fax:
Practice Address - Street 1:625 N SANDUSKY AVE
Practice Address - Street 2:
Practice Address - City:UPPER SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:43351-1037
Practice Address - Country:US
Practice Address - Phone:419-294-5795
Practice Address - Fax:419-294-5795
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE2722101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH861155827OtherTAX ID