Provider Demographics
NPI:1821173451
Name:JONES, HEATHER SUSAN (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:SUSAN
Last Name:JONES
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MRS
Other - First Name:HEATHER
Other - Middle Name:SUSAN
Other - Last Name:HANLON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT
Mailing Address - Street 1:787 MAIN STREET SOUTH
Mailing Address - Street 2:SUITE A5
Mailing Address - City:WOODBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06798
Mailing Address - Country:US
Mailing Address - Phone:203-903-9712
Mailing Address - Fax:
Practice Address - Street 1:787 MAIN ST S UNIT A-5
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:CT
Practice Address - Zip Code:06798-3741
Practice Address - Country:US
Practice Address - Phone:203-903-9712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001074106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTCPHP008441Medicaid