Provider Demographics
NPI:1235604786
Name:JONES, JODY (LMFT)
Entity Type:Individual
Prefix:
First Name:JODY
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1365 N CUSTER ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-6694
Mailing Address - Country:US
Mailing Address - Phone:316-942-4261
Mailing Address - Fax:316-943-9995
Practice Address - Street 1:1365 N CUSTER ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-6694
Practice Address - Country:US
Practice Address - Phone:316-942-4261
Practice Address - Fax:316-943-9995
Is Sole Proprietor?:No
Enumeration Date:2018-10-11
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2998106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist