Healthcare Provider Details

I. General information

NPI: 1356770663
Provider Name (Legal Business Name): JANIE MARIE CALHOUN LICDC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2013
Last Update Date: 02/04/2026
Certification Date: 02/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 LEGACY DR
BEREA KY
40403-9594
US

IV. Provider business mailing address

PO BOX 46193
CINCINNATI OH
45246-0193
US

V. Phone/Fax

Practice location:
  • Phone: 859-986-2323
  • Fax:
Mailing address:
  • Phone: 513-293-7434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number258643
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberI.1700441-SUPV
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberICDC. 011285
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: