Provider Demographics
NPI:1417132440
Name:THOMAS-JONES, ANGELA G (LCMHC, MLADC)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:G
Last Name:THOMAS-JONES
Suffix:
Gender:F
Credentials:LCMHC, MLADC
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:T
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCMHC, MLADC
Mailing Address - Street 1:PO BOX 445
Mailing Address - Street 2:
Mailing Address - City:FRANCONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03580-0445
Mailing Address - Country:US
Mailing Address - Phone:603-616-2019
Mailing Address - Fax:603-761-7255
Practice Address - Street 1:845 OLD FRANCONIA RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:NH
Practice Address - Zip Code:03574-5875
Practice Address - Country:US
Practice Address - Phone:603-444-1039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-09
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC6812101YM0800X, 101YA0400X
NH1109101YM0800X
MNCC04379101YA0400X, 101YM0800X
NH0291101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1417132440OtherMN BOARD OF BEHAVIORAL HEALTH
NH3097523Medicaid
VT1028825Medicaid
VA0701011190OtherLPC LICENSE NUMBER FOR VIRGINIA
MECC6812OtherLPC LICENSE NUMBER FOR MAINE