Provider Demographics
NPI:1225253529
Name:JONES, KATHY
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2421 BEEKAY CT
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22181-3002
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2915 HUNTER MILL RD
Practice Address - Street 2:SUITE 14
Practice Address - City:OAKTON
Practice Address - State:VA
Practice Address - Zip Code:22124-1716
Practice Address - Country:US
Practice Address - Phone:703-242-0245
Practice Address - Fax:703-242-7110
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001777101YP2500X
VA0717000345106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist