Provider Demographics
NPI:1689205742
Name:JONES, RACHAEL ERIN MARTIN (LMFT)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:ERIN MARTIN
Last Name:JONES
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:RACHAEL
Other - Middle Name:ERIN
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1227 W GLENN LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-4062
Mailing Address - Country:US
Mailing Address - Phone:847-707-3195
Mailing Address - Fax:
Practice Address - Street 1:1227 W GLENN LN
Practice Address - Street 2:
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-4062
Practice Address - Country:US
Practice Address - Phone:847-707-3195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-28
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208.0007931041C0700X
IL166001480101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL166001480OtherILLINOIS STATE LICENSE