Provider Demographics
NPI:1356147789
Name:JONES, LAURA ANN (LIAC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:JONES
Suffix:
Gender:
Credentials:LIAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2120 E BLUEFIELD AVE LOT 134
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-1447
Mailing Address - Country:US
Mailing Address - Phone:602-703-7134
Mailing Address - Fax:
Practice Address - Street 1:2120 E BLUEFIELD AVE LOT 134
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-1447
Practice Address - Country:US
Practice Address - Phone:602-703-7134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLIAC-155333101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)