Provider Demographics
NPI:1336256759
Name:JONES, JANI R (LCPC)
Entity Type:Individual
Prefix:MISS
First Name:JANI
Middle Name:R
Last Name:JONES
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:P.O. BOX 100
Mailing Address - Street 2:GOYA HEALTH LTD.
Mailing Address - City:ENERGY
Mailing Address - State:IL
Mailing Address - Zip Code:62933
Mailing Address - Country:US
Mailing Address - Phone:618-988-9843
Mailing Address - Fax:618-942-8640
Practice Address - Street 1:202 S. PERSHING ST.
Practice Address - Street 2:GOYA HEALTH LTD.
Practice Address - City:ENERGY
Practice Address - State:IL
Practice Address - Zip Code:62933
Practice Address - Country:US
Practice Address - Phone:618-988-9843
Practice Address - Fax:618-942-8640
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-002852101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL133625759OtherNPI