Provider Demographics
NPI:1083674592
Name:JONES, KRISTIN NOELLE (LPC)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:NOELLE
Last Name:JONES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:NOELLE
Other - Last Name:MCDONALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:684 E VINE ST STE 4A
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-5540
Mailing Address - Country:US
Mailing Address - Phone:801-380-3846
Mailing Address - Fax:801-293-7106
Practice Address - Street 1:684 E VINE ST STE 4A
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-5540
Practice Address - Country:US
Practice Address - Phone:801-380-3846
Practice Address - Fax:801-293-7106
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-27
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4971398-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health