Provider Demographics
NPI:1306001086
Name:JONES, REGINA RENEE (LCDC)
Entity Type:Individual
Prefix:MS
First Name:REGINA
Middle Name:RENEE
Last Name:JONES
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6806 DARIEN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77028-3920
Mailing Address - Country:US
Mailing Address - Phone:713-633-2707
Mailing Address - Fax:
Practice Address - Street 1:8240 ANTOINE DR STE 104
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77088-2522
Practice Address - Country:US
Practice Address - Phone:281-999-0938
Practice Address - Fax:281-999-0938
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-22
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10027101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX161469501Medicaid