Provider Demographics
NPI:1699036640
Name:JONES, LARAN PATRICE (COUNSELOR)
Entity Type:Individual
Prefix:MS
First Name:LARAN
Middle Name:PATRICE
Last Name:JONES
Suffix:
Gender:F
Credentials:COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3217 RAGSDALE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29209-4458
Mailing Address - Country:US
Mailing Address - Phone:843-252-5672
Mailing Address - Fax:
Practice Address - Street 1:3217 RAGSDALE DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29209-4458
Practice Address - Country:US
Practice Address - Phone:843-252-5672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor