Provider Demographics
NPI:1760100937
Name:JONES, KATRINA (LPCA)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:LPCA
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 8263
Mailing Address - Street 2:
Mailing Address - City:COBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97408-1310
Mailing Address - Country:US
Mailing Address - Phone:541-870-7914
Mailing Address - Fax:
Practice Address - Street 1:1100 JACOBS DR UNIT B
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-1983
Practice Address - Country:US
Practice Address - Phone:541-870-7914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR7776101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional