Provider Demographics
NPI:1336463827
Name:JONES, CASEY O'DONNELL (LPC)
Entity Type:Individual
Prefix:MRS
First Name:CASEY
Middle Name:O'DONNELL
Last Name:JONES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:CASEY
Other - Middle Name:ANN
Other - Last Name:O'DONNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PLPC
Mailing Address - Street 1:112 CENTRE ON THE LK
Mailing Address - Street 2:
Mailing Address - City:LAKE SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63367-1369
Mailing Address - Country:US
Mailing Address - Phone:636-544-7370
Mailing Address - Fax:
Practice Address - Street 1:112 CENTRE ON THE LK
Practice Address - Street 2:
Practice Address - City:LAKE SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63367-1369
Practice Address - Country:US
Practice Address - Phone:636-544-7370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-26
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010006425101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional