Provider Demographics
NPI:1831671791
Name:JONES, KRISTIN (LCASA, LCSW)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:JONES
Suffix:
Gender:
Credentials:LCASA, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7741 MARKET ST STE A
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411-9444
Mailing Address - Country:US
Mailing Address - Phone:910-548-7973
Mailing Address - Fax:
Practice Address - Street 1:7741 MARKET ST STE A
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28411-9444
Practice Address - Country:US
Practice Address - Phone:910-548-7973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-06
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-23221101YA0400X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)