Provider Demographics
NPI:1265652788
Name:JONES, PATRICIA M (LPC, LCDC)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:M
Last Name:JONES
Suffix:
Gender:F
Credentials:LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 MIRAFIELD LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78737-4676
Mailing Address - Country:US
Mailing Address - Phone:917-568-1081
Mailing Address - Fax:
Practice Address - Street 1:139 MIRAFIELD LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78737-4676
Practice Address - Country:US
Practice Address - Phone:917-568-1081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001679101YM0800X
TX75323101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health