Provider Demographics
NPI:1629938972
Name:JONES, LATEISE (LCPC)
Entity type:Individual
Prefix:
First Name:LATEISE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7504 MARSTON RD
Mailing Address - Street 2:
Mailing Address - City:GWYNN OAK
Mailing Address - State:MD
Mailing Address - Zip Code:21207-4559
Mailing Address - Country:US
Mailing Address - Phone:502-507-4045
Mailing Address - Fax:
Practice Address - Street 1:400 W CHESAPEAKE AVE
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-4342
Practice Address - Country:US
Practice Address - Phone:410-961-3499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-17
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC16726101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral