Provider Demographics
NPI:1023428208
Name:JONES, KATIE (LMHC, CSAYC)
Entity type:Individual
Prefix:MS
First Name:KATIE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:LMHC, CSAYC
Other - Prefix:MRS
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:BERNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC, CSAYC
Mailing Address - Street 1:101 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46952-3867
Mailing Address - Country:US
Mailing Address - Phone:765-662-9971
Mailing Address - Fax:765-651-6556
Practice Address - Street 1:101 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46952-3867
Practice Address - Country:US
Practice Address - Phone:765-662-9971
Practice Address - Fax:765-651-6556
Is Sole Proprietor?:No
Enumeration Date:2014-04-28
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1780734806Medicaid
IN567370OtherVALUE OPTIONS
IN000000959170OtherANTHEM BC/BS
IN4027OtherMPLAN