Provider Demographics
NPI:1568589406
Name:JONES, KELLEY SIMMONS (LMHC)
Entity Type:Individual
Prefix:
First Name:KELLEY
Middle Name:SIMMONS
Last Name:JONES
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:SYNCHRONICITY
Other - Middle Name:
Other - Last Name:LLC
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1229
Mailing Address - Street 2:
Mailing Address - City:RAINIER
Mailing Address - State:WA
Mailing Address - Zip Code:98576-1229
Mailing Address - Country:US
Mailing Address - Phone:360-970-2135
Mailing Address - Fax:
Practice Address - Street 1:1800 COOPER POINT RD SW STE 17
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-1179
Practice Address - Country:US
Practice Address - Phone:360-970-2135
Practice Address - Fax:360-890-4924
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00007913101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health