Provider Demographics
NPI:1164762928
Name:RITKE JONES, JACKIE (LCMHC)
Entity Type:Individual
Prefix:
First Name:JACKIE
Middle Name:
Last Name:RITKE JONES
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:297 LAIRD POND RD
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05667-9137
Mailing Address - Country:US
Mailing Address - Phone:802-224-6001
Mailing Address - Fax:
Practice Address - Street 1:5 HIGH SCHOOL DR
Practice Address - Street 2:
Practice Address - City:MONTPELIER
Practice Address - State:VT
Practice Address - Zip Code:05602-3344
Practice Address - Country:US
Practice Address - Phone:802-224-6001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-15
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068.0083749101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health