Provider Demographics
NPI:1770502239
Name:JONES, CAROL BUCHANAN (LPC)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:BUCHANAN
Last Name:JONES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9115 CROSS CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39503-6116
Mailing Address - Country:US
Mailing Address - Phone:228-896-8983
Mailing Address - Fax:228-896-3728
Practice Address - Street 1:1856 BEACH DR
Practice Address - Street 2:PSYCHOLOGY AND COUNSELING
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39507-1508
Practice Address - Country:US
Practice Address - Phone:228-897-7237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS0957101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional