MEDICARE: MS. JANET SUSAN BIENEN LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	0701003526	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11459118	OTHER		CAQH

General Provider Information

NPI Number	:	1326045725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JANET SUSAN BIENEN LPC

Provider Business Mailing Address
First Line	:	127 E. MAIN STREET
Second Line	:
City	:	LURAY
State	:	VA
Zip	:	22835-1564
Country	:	US
Telephone Number	:	540-843-0505
Fax Number	:	540-843-0505

Provider Business Practice Location Address
First Line	:	127 E. MAIN STREET
Second Line	:	PAGE COUNTY COUNSELING, PLC
City	:	LURAY
State	:	VA
Zip	:	22835
Country	:	US
Telephone Number	:	540-843-0505
Fax Number	:	540-843-0505

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	04/06/2011

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