Provider Demographics
NPI:1083187926
Name:JONES, LAKEESHA MONIQUE (LCMHC, LCAS-A, NCC)
Entity Type:Individual
Prefix:
First Name:LAKEESHA
Middle Name:MONIQUE
Last Name:JONES
Suffix:
Gender:F
Credentials:LCMHC, LCAS-A, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 W 35TH ST
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-2815
Mailing Address - Country:US
Mailing Address - Phone:910-740-8982
Mailing Address - Fax:
Practice Address - Street 1:5075 MORGANTON RD
Practice Address - Street 2:STE 10C #1148
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314
Practice Address - Country:US
Practice Address - Phone:910-502-0778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-03
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-25409101YA0400X
NCA13953101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1083187926Medicaid