Provider Demographics
NPI:1609555465
Name:JONES, KANDYCE (LGPC)
Entity Type:Individual
Prefix:
First Name:KANDYCE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1855 SAINT FRANCIS ST APT 1305
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-6253
Mailing Address - Country:US
Mailing Address - Phone:773-575-0294
Mailing Address - Fax:
Practice Address - Street 1:1855 SAINT FRANCIS ST APT 1305
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-6253
Practice Address - Country:US
Practice Address - Phone:773-575-0294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP13863101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional