Provider Demographics
NPI:1902956485
Name:RUNYAN, JANET M (MS, LPC)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:M
Last Name:RUNYAN
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11723 OLD GLENN HWY
Mailing Address - Street 2:SUITE 204
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-7733
Mailing Address - Country:US
Mailing Address - Phone:907-696-4041
Mailing Address - Fax:907-696-4041
Practice Address - Street 1:11723 OLD GLENN HWY
Practice Address - Street 2:SUITE 204
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-7733
Practice Address - Country:US
Practice Address - Phone:907-696-4041
Practice Address - Fax:907-696-4041
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK#311101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional