Provider Demographics
NPI:1871569624
Name:JONES, MICHAEL RYAN (LPC)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:RYAN
Last Name:JONES
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:10025 WEST MARKHAM ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205
Mailing Address - Country:US
Mailing Address - Phone:501-663-5473
Mailing Address - Fax:501-801-1816
Practice Address - Street 1:3604 CENTRAL AVE
Practice Address - Street 2:SUITE C
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913
Practice Address - Country:US
Practice Address - Phone:501-624-7111
Practice Address - Fax:501-620-5109
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2017-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA0505036101YM0800X
ARP0802019101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1871569624OtherBCBS
AR1871569624OtherNOVA SYSTEMS
AR116399726Medicaid
AR710401764OtherCORP HEALTH
AR1871569624OtherTRICARE - STANDARD
AR1871569624OtherUNITY MGED MH (A/K/A ST JOHN'S MERCY HEALTH)
AR08050011000OtherQUAL-CHOICE
AR2565557OtherCIGNA
AR420017OtherMHN