Provider Demographics
NPI:1649387978
Name:JONES, BARBARA D (LAC)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:D
Last Name:JONES
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59401-3764
Mailing Address - Country:US
Mailing Address - Phone:406-268-1510
Mailing Address - Fax:
Practice Address - Street 1:1220 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-3764
Practice Address - Country:US
Practice Address - Phone:406-268-1510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP00000760101YA0400X
MTBBH-LAC-LIC-32803101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPO1521OtherREGENCE RIDER#
WA910875163-19OtherKPS ID#
WA1992825Medicaid
MTBBH-LAC-LIC-32803OtherSTATE OF MONTANA BOARD OF BEHAVIORAL HEALTH