Basic Information
| Provider Information | |||||||||
| NPI: | 1376512079 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROARABAUGH | ||||||||
| FirstName: | JANET | ||||||||
| MiddleName: | L. | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.ED., NCC, LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 601 WILSON AVE | ||||||||
| Address2: | |||||||||
| City: | ROARING SPRING | ||||||||
| State: | PA | ||||||||
| PostalCode: | 166731351 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8142410471 | ||||||||
| FaxNumber: | 8143170341 | ||||||||
| Practice Location | |||||||||
| Address1: | 601 WILSON AVE | ||||||||
| Address2: | |||||||||
| City: | ROARING SPRING | ||||||||
| State: | PA | ||||||||
| PostalCode: | 166731351 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8142410471 | ||||||||
| FaxNumber: | 8143170341 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/15/2006 | ||||||||
| LastUpdateDate: | 01/15/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | PC 000178 | PA | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
ID Information
| ID | Type | State | Issuer | Description | 1423594 | 01 | PA | HIGHMARK | OTHER | 7032352 | 01 | PA | AETNA | OTHER | 1019754560003 | 05 | PA | MEDICAID |