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Individual

MRS. JEAN A HALFAST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW, LCAC

Contact information

Practice address
401 E 8TH ST, SUITE A, ROCHESTER, IN 46975-1443
(574) 223-8565
(574) 223-8786
Mailing address
1015 MICHIGAN AVE, LOGANSPORT, IN 46947-1526
(574) 722-5151
(574) 739-1414

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34004818A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000184311
ANTHEM
IN
01
111810013
MEDICARE
IN
Enumeration date
06/29/2006
Last updated
06/28/2019
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