Individual
JANICE I TETHEROW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA,CPC,LMHP,NCC
Contact information
Practice address
442 N CHERRY ST, VALENTINE, NE 69201-1516
(402) 376-1000
Mailing address
442 N CHERRY ST, VALENTINE, NE 69201-1516
(402) 376-1000
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1754
NE
101YM0800X
Mental Health Counselor
387
NE
101YP2500X
Professional Counselor
1051
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11555
MIDLANDS CHOICE
—
05
—
47055423826
—
NE
01
—
84907
BLUE CROSS BLUE SHIELD
NE
Enumeration date
09/22/2006
Last updated
11/07/2008
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