Provider Demographics
NPI:1225336803
Name:JONES, LAURA FELSTED (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:FELSTED
Last Name:JONES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:FELSTED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1112 SOUTH 1000 EAST #5
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84606-5071
Mailing Address - Country:US
Mailing Address - Phone:801-696-7923
Mailing Address - Fax:
Practice Address - Street 1:1112 SOUTH 1000 EAST #5
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84606-5071
Practice Address - Country:US
Practice Address - Phone:801-696-7923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-07
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172V00000X
UT7198021-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT7198021-3501OtherLCSW LICENSE #