Provider Demographics
NPI:1578997722
Name:JONES, KAREN LYNN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:LYNN
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1429 W KEMPER RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-1630
Mailing Address - Country:US
Mailing Address - Phone:513-310-6422
Mailing Address - Fax:
Practice Address - Street 1:4000 EXECUTIVE PARK DR STE 100
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-2023
Practice Address - Country:US
Practice Address - Phone:513-400-4454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-23
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLE-00024235101YP2500X
OHE.1200146-SUPV101YP2500X
OHCS.00000031101YA0400X
OHLICDC.161162101YA0400X
OHC.1200146-TRNE101YM0800X
OHC.1200146101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0196310Medicaid