Provider Demographics
NPI:1073089686
Name:BARTHOLOMEW-JONES, LA CHANDRA CYNTRISE (LPC, NCC, MAC, AADC)
Entity Type:Individual
Prefix:
First Name:LA CHANDRA
Middle Name:CYNTRISE
Last Name:BARTHOLOMEW-JONES
Suffix:
Gender:F
Credentials:LPC, NCC, MAC, AADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8240 AL HIGHWAY 204
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36265-5605
Mailing Address - Country:US
Mailing Address - Phone:770-843-9557
Mailing Address - Fax:
Practice Address - Street 1:8240 AL HIGHWAY 204
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:AL
Practice Address - Zip Code:36265-5605
Practice Address - Country:US
Practice Address - Phone:770-843-9557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-22
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3757101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor