Provider Demographics
NPI:1235993080
Name:JONES, LONNIE (LICDC)
Entity Type:Individual
Prefix:MR
First Name:LONNIE
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 N ARLINGTON ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44305-2406
Mailing Address - Country:US
Mailing Address - Phone:234-716-9764
Mailing Address - Fax:
Practice Address - Street 1:105 N ARLINGTON ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44305-2406
Practice Address - Country:US
Practice Address - Phone:234-716-9764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH121038101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)