Provider Demographics
NPI:1972749562
Name:JONES, PHYLLIS J (LPC)
Entity Type:Individual
Prefix:DR
First Name:PHYLLIS
Middle Name:J
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 1:4920 MILLRIDGE PKWY E
Mailing Address - Street 2:STE 206
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-4857
Mailing Address - Country:US
Mailing Address - Phone:804-378-5263
Mailing Address - Fax:
Practice Address - Street 1:4920 MILLRIDGE PKWY E
Practice Address - Street 2:STE 206
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-4857
Practice Address - Country:US
Practice Address - Phone:804-378-5263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-02
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001486101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional