Provider Demographics
NPI:1871131847
Name:JONES, JARED MICHAEL (LMHCA)
Entity type:Individual
Prefix:
First Name:JARED
Middle Name:MICHAEL
Last Name:JONES
Suffix:
Gender:M
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10080 E US HIGHWAY 36 STE A
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-8174
Mailing Address - Country:US
Mailing Address - Phone:317-790-9396
Mailing Address - Fax:
Practice Address - Street 1:10080 E US HIGHWAY 36 STE A
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-8174
Practice Address - Country:US
Practice Address - Phone:317-790-9396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-20
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN88001027A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN88001027AOtherINDIANA PROFESSIONAL LICENSING AGENCY