Provider Demographics
NPI:1508034075
Name:JONES, AMIE K (BHC II, CDC I)
Entity Type:Individual
Prefix:
First Name:AMIE
Middle Name:K
Last Name:JONES
Suffix:
Gender:F
Credentials:BHC II, CDC I
Other - Prefix:
Other - First Name:AMIE
Other - Middle Name:K
Other - Last Name:ARNOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BHC II, CDC I
Mailing Address - Street 1:1526 E REZANOF DR
Mailing Address - Street 2:
Mailing Address - City:KODIAK
Mailing Address - State:AK
Mailing Address - Zip Code:99615-6501
Mailing Address - Country:US
Mailing Address - Phone:907-512-9892
Mailing Address - Fax:
Practice Address - Street 1:1526 E REZANOF DR
Practice Address - Street 2:
Practice Address - City:KODIAK
Practice Address - State:AK
Practice Address - Zip Code:99615-6501
Practice Address - Country:US
Practice Address - Phone:907-512-9892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-18
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK3628101Y00000X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor