Provider Demographics
NPI:1780915348
Name:JONES, CAROLINE GRACE (JERNIGAN) (LMFT)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:GRACE (JERNIGAN)
Last Name:JONES
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1113 E FRANKLIN AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-2974
Mailing Address - Country:US
Mailing Address - Phone:612-747-2121
Mailing Address - Fax:612-729-7834
Practice Address - Street 1:1113 E FRANKLIN AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-2974
Practice Address - Country:US
Practice Address - Phone:612-276-7052
Practice Address - Fax:612-729-7834
Is Sole Proprietor?:No
Enumeration Date:2010-01-21
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1909106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist