Provider Demographics
NPI:1447598669
Name:JONES, MYRON D (LPC, LCDC)
Entity Type:Individual
Prefix:MR
First Name:MYRON
Middle Name:D
Last Name:JONES
Suffix:
Gender:M
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 1:9535 FOREST LN STE 258
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-5900
Mailing Address - Country:US
Mailing Address - Phone:214-838-3660
Mailing Address - Fax:214-504-1337
Practice Address - Street 1:9535 FOREST LN STE 258
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-5900
Practice Address - Country:US
Practice Address - Phone:214-838-3660
Practice Address - Fax:214-504-1337
Is Sole Proprietor?:No
Enumeration Date:2013-01-23
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11861101YA0400X
TX67857101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)