Provider Demographics
NPI:1326248790
Name:JONES, THERESA G (MA, LCMHC, LCAS)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:G
Last Name:JONES
Suffix:
Gender:F
Credentials:MA, LCMHC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8853 THORNTON TOWN PL
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-8064
Mailing Address - Country:US
Mailing Address - Phone:919-327-0009
Mailing Address - Fax:
Practice Address - Street 1:223 US HIGHWAY 70 E
Practice Address - Street 2:SUITE 150-A
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-4071
Practice Address - Country:US
Practice Address - Phone:919-412-3960
Practice Address - Fax:919-516-4252
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6651101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional