Provider Demographics
NPI:1235502998
Name:JONES, BRANDY M (LCPC)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:M
Last Name:JONES
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2302 W NORTH AVE
Mailing Address - Street 2:1E
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-6260
Mailing Address - Country:US
Mailing Address - Phone:872-216-6451
Mailing Address - Fax:
Practice Address - Street 1:2302 W NORTH AVE
Practice Address - Street 2:1E
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-6260
Practice Address - Country:US
Practice Address - Phone:872-216-6451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-03
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.009804101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health