MEDICARE: MS. JANET LUSHBAUGH 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	LPC #0504	MS

General Provider Information

NPI Number	:	1619060969
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JANET LUSHBAUGH LPC

Provider Business Mailing Address
First Line	:	207 NORTHWIND DR
Second Line	:
City	:	BRANDON
State	:	MS
Zip	:	39047-8683
Country	:	US
Telephone Number	:	601-952-0515
Fax Number	:	601-952-2955

Provider Business Practice Location Address
First Line	:	357 TOWNE CENTER BLVD
Second Line	:	SUITE 402
City	:	RIDGELAND
State	:	MS
Zip	:	39157-4837
Country	:	US
Telephone Number	:	601-952-0515
Fax Number	:	601-952-2955

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

Provider Enumeration Date	:	10/01/2006
Last Update Date	:	07/08/2007

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