Provider Demographics
NPI:1114353158
Name:JONES, KATHLEEN NICOLE (LPC)
Entity Type:Individual
Prefix:MISS
First Name:KATHLEEN
Middle Name:NICOLE
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 1:3444 DUNDEE RD
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2201
Mailing Address - Country:US
Mailing Address - Phone:847-559-0110
Mailing Address - Fax:847-559-8199
Practice Address - Street 1:3444 DUNDEE RD
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2201
Practice Address - Country:US
Practice Address - Phone:847-559-0110
Practice Address - Fax:847-559-8199
Is Sole Proprietor?:No
Enumeration Date:2013-09-23
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178009017101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional