Provider Demographics
NPI:1821806688
Name:JONES, MIRANDA CLAIRE (LPC)
Entity type:Individual
Prefix:
First Name:MIRANDA
Middle Name:CLAIRE
Last Name:JONES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8820 SOUTHWESTERN BLVD APT 1305
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-2825
Mailing Address - Country:US
Mailing Address - Phone:214-663-0462
Mailing Address - Fax:
Practice Address - Street 1:2150 LAKESIDE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-4467
Practice Address - Country:US
Practice Address - Phone:972-437-4698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-26
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX91145101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty