Provider Demographics
NPI:1083274856
Name:JONES, ELAYNE KRISTEN (LPC)
Entity Type:Individual
Prefix:
First Name:ELAYNE
Middle Name:KRISTEN
Last Name:JONES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 W TIOGA ST
Mailing Address - Street 2:
Mailing Address - City:TUNKHANNOCK
Mailing Address - State:PA
Mailing Address - Zip Code:18657-1496
Mailing Address - Country:US
Mailing Address - Phone:570-836-2722
Mailing Address - Fax:570-836-1068
Practice Address - Street 1:133 W TIOGA ST
Practice Address - Street 2:
Practice Address - City:TUNKHANNOCK
Practice Address - State:PA
Practice Address - Zip Code:18657-1496
Practice Address - Country:US
Practice Address - Phone:570-836-2722
Practice Address - Fax:570-836-1068
Is Sole Proprietor?:No
Enumeration Date:2019-06-14
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011449101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor