Provider Demographics
NPI:1578887360
Name:JONES, RENEE S (LPC)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:S
Last Name:JONES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1931 JN PEASE PL
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-4544
Mailing Address - Country:US
Mailing Address - Phone:704-717-2800
Mailing Address - Fax:704-717-6200
Practice Address - Street 1:1931 JN PEASE PL
Practice Address - Street 2:SUITE 202
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-4544
Practice Address - Country:US
Practice Address - Phone:704-717-2800
Practice Address - Fax:704-717-6200
Is Sole Proprietor?:No
Enumeration Date:2010-03-23
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005722101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional