Provider Demographics
NPI:1629383237
Name:JONES, TAMARA (MA, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1102
Mailing Address - Street 2:
Mailing Address - City:MINTURN
Mailing Address - State:CO
Mailing Address - Zip Code:81645-1102
Mailing Address - Country:US
Mailing Address - Phone:970-376-3480
Mailing Address - Fax:
Practice Address - Street 1:384 MAIN STREET
Practice Address - Street 2:
Practice Address - City:MINTURN
Practice Address - State:CO
Practice Address - Zip Code:81645
Practice Address - Country:US
Practice Address - Phone:970-376-3480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-09
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5330101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional