Provider Demographics
NPI:1497047534
Name:JONES, KATIE LYNN (LCPC)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:LYNN
Last Name:JONES
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3089
Mailing Address - Street 2:CENTER FOR MENTAL HEALTH
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59403-3089
Mailing Address - Country:US
Mailing Address - Phone:406-278-3205
Mailing Address - Fax:406-278-7260
Practice Address - Street 1:514 S FRONT ST STE 1
Practice Address - Street 2:CENTER FOR MENTAL HEALTH
Practice Address - City:CONRAD
Practice Address - State:MT
Practice Address - Zip Code:59425-2538
Practice Address - Country:US
Practice Address - Phone:406-278-3205
Practice Address - Fax:406-278-7260
Is Sole Proprietor?:No
Enumeration Date:2011-05-09
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1559-LCPC101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000746700OtherBLUE CROSS-SHIELD OF MONTANA