Provider Demographics
NPI:1124372891
Name:JONES, AMANDA LYNN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:LYNN
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 1:895 STUBB ST SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97306-1239
Mailing Address - Country:US
Mailing Address - Phone:503-602-0545
Mailing Address - Fax:503-776-7223
Practice Address - Street 1:1140 BAXTER RD SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97306-1528
Practice Address - Country:US
Practice Address - Phone:503-602-0545
Practice Address - Fax:503-408-5021
Is Sole Proprietor?:No
Enumeration Date:2012-11-02
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC5586101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health