Provider Demographics
NPI:1164827085
Name:MASTERS, JANICE JEANE
Entity type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:JEANE
Last Name:MASTERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:JEANE
Other - Last Name:GREENE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LLPC
Mailing Address - Street 1:213 GOLDEN AVE
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-3856
Mailing Address - Country:US
Mailing Address - Phone:269-965-6058
Mailing Address - Fax:
Practice Address - Street 1:110 KNAPP DR
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-4111
Practice Address - Country:US
Practice Address - Phone:269-830-1318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI449577101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional