Provider Demographics
NPI:1235996331
Name:JONES, KIMBERLY MONIQUE (LGPC)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:MONIQUE
Last Name:JONES
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7722 ALTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ABBOTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17301-8978
Mailing Address - Country:US
Mailing Address - Phone:443-677-5720
Mailing Address - Fax:
Practice Address - Street 1:5457 TWIN KNOLLS RD STE 300
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-3296
Practice Address - Country:US
Practice Address - Phone:443-709-8377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-05
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP14892101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional