Provider Demographics
NPI:1578586210
Name:JONES, LISA G (LCSW)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:G
Last Name:JONES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1539 JUNE DR
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-2301
Mailing Address - Country:US
Mailing Address - Phone:225-405-5367
Mailing Address - Fax:
Practice Address - Street 1:3080 TEDDY DR STE A
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-1925
Practice Address - Country:US
Practice Address - Phone:225-405-5367
Practice Address - Fax:888-505-1026
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4713101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health