Provider Demographics
NPI:1548667108
Name:HUBBLE, JANIE RENEA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JANIE
Middle Name:RENEA
Last Name:HUBBLE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:JANIE
Other - Middle Name:RENEA
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:6745 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:IN
Mailing Address - Zip Code:46064-9026
Mailing Address - Country:US
Mailing Address - Phone:765-778-0881
Mailing Address - Fax:
Practice Address - Street 1:6745 SPRING ST
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:IN
Practice Address - Zip Code:46064-9026
Practice Address - Country:US
Practice Address - Phone:765-778-0881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-25
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34000722A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical